title: Immunological aspects of nonimmediate reactions to beta-lactam antibiotics.
abstract: beta-lactam antibiotics are the agents most frequently implied in immune drug adverse reactions. These can be classified as immediate or nonimmediate according to the time interval between the last drug administration and their onset. Mechanisms of immediate IgE-mediated reactions are widely studied and are therefore better understood. Nonimmediate reactions include a broad number of clinical entities like mild maculopapular exanthemas, the most common, and other less frequent but more severe reactions such as Stevens-Johnson syndrome, toxic epidermal necrolysis, acute exanthematic pustulosis or cytopenias. These nonimmediate reactions are mainly mediated by T cells but the precise underlying mechanisms are not well elucidated. This fact complicates the allergological evaluation of patients with this type of reaction and available tests have demonstrated poor sensitivity and specificity.
authors.affiliation: Allergy department, University Hospital of Salamanca, 37007 Salamanca, Spain.
authors.forename: Esther Morena
authors.initials: EM
authors.lastname: Rodilla
authors.forename: Ignacio Dávila
authors.initials: ID
authors.lastname: González
authors.forename: Elena Laffond
authors.initials: EL
authors.lastname: Yges
authors.forename: Francisco Javier Múñoz
authors.initials: FJ
authors.lastname: Bellido
authors.forename: María Teresa Gracia
authors.initials: MT
authors.lastname: Bara
authors.forename: Félix Lorente
authors.initials: FL
authors.lastname: Toledano
mesh_terms: D056150:Acute Generalized Exanthematous Pustulosis; D005076:Exanthema; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D007970:Leukopenia; D013262:Stevens-Johnson Syndrome; D013601:T-Lymphocytes / Q000276:immunology*; D047090:beta-Lactams / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D047090:beta-Lactams