title: Hypersensitivity to antibiotics in patients with cystic fibrosis.
abstract: BACKGROUND
  Hypersensitivity reactions to parenterally administered antibiotics (HRPA) are a substantial problem in managing CF. We conducted this observational study to assess their nature and frequency as well as risk factors.
  
  
  METHODS
  By reviewing medical records and conducting interviews, age, sex, FEV1, ∆F508-genotype, pseudomonal colonisation, allergy history, antibiotic exposure and HRPA were recorded.
  
  
  RESULTS
  Of 100 patients included in the study, 60 had ≥1 HRPA. Overall, 3205 antibiotic courses with 185 HRPA were ascertained. Changes in therapy followed 65% of HRPA. Eighty-four percent of severe HRPA occurred during days 1-4. Approximately 10% of treatment courses with cefepime and piperacillin/tazobactam caused HRPA. Years of pseudomonal colonisation and cumulative annual exposure were significant risk factors.
  
  
  CONCLUSIONS
  During days 1-4 of antibiotic treatment patients are at elevated risk for HRPA. HRPA are drug-specific and dependent on cumulative annual exposure. Elucidation of HRPA's immunological mechanisms and development of diagnostic algorithms for clinical use are required.
authors.affiliation: Division of Cystic Fibrosis, Pediatric Pneumology and Immunology, University Children's Hospital, Charité University Medicine, Augustenburger Platz 1, 13353 - Berlin, Germany; Division of Allergology, Pediatric Pneumology and Immunology, University Children's Hospital, Charité University Medicine, Augustenburger Platz 1, 13353 - Berlin, Germany. Electronic address: jobst.roehmel@charite.de.
authors.forename: Jobst Fridolin
authors.initials: JF
authors.lastname: Roehmel
authors.affiliation: Division of Cystic Fibrosis, Pediatric Pneumology and Immunology, University Children's Hospital, Charité University Medicine, Augustenburger Platz 1, 13353 - Berlin, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Schwarz
authors.affiliation: Division of Cystic Fibrosis, Pediatric Pneumology and Immunology, University Children's Hospital, Charité University Medicine, Augustenburger Platz 1, 13353 - Berlin, Germany; Division of Allergology, Pediatric Pneumology and Immunology, University Children's Hospital, Charité University Medicine, Augustenburger Platz 1, 13353 - Berlin, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Mehl
authors.affiliation: Division of Cystic Fibrosis, Pediatric Pneumology and Immunology, University Children's Hospital, Charité University Medicine, Augustenburger Platz 1, 13353 - Berlin, Germany; Division of Allergology, Pediatric Pneumology and Immunology, University Children's Hospital, Charité University Medicine, Augustenburger Platz 1, 13353 - Berlin, Germany.
authors.forename: Philippe
authors.initials: P
authors.lastname: Stock
authors.affiliation: Division of Cystic Fibrosis, Pediatric Pneumology and Immunology, University Children's Hospital, Charité University Medicine, Augustenburger Platz 1, 13353 - Berlin, Germany; Division of Allergology, Pediatric Pneumology and Immunology, University Children's Hospital, Charité University Medicine, Augustenburger Platz 1, 13353 - Berlin, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Staab
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification; D002648:Child; D003550:Cystic Fibrosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D011552:Pseudomonas Infections / Q000517:prevention & control*; D020379:Risk Adjustment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: Allergy; Antibiotic treatment; Antibiotics; Aztreonam; Ceftazidime; Colistin; Cystic fibrosis; Drug Allergy; Drug hypersensitivity; Hypersensitivity; Piperacillin; Tazobactam