title: Immediate-type hypersensitivity reactions due to antituberculosis drugs: a successful readministration protocol.
abstract: BACKGROUND
  Little is known about drug hypersensitivity reactions from antituberculosis drugs.
  
  
  OBJECTIVE
  To determine the frequency, risk factors, and characteristics of immediate-type hypersensitivity reactions from first-line antituberculosis drugs and to evaluate the usefulness of a readministration protocol for culprit drugs in this group of patients.
  
  
  METHODS
  The study population consisted of patients with tuberculosis who were hospitalized and treated in the authors' hospital in 2011. Demographics and disease and treatment characteristics of patients with immediate-type hypersensitivity from antituberculosis drugs were compared with the other patients. Culprit drugs were readministered gradually according to a defined protocol to patients with immediate-type hypersensitivity.
  
  
  RESULTS
  Tree hundred seventy-nine patients were included in the study. Eighteen immediate-type hypersensitivity reactions were detected in 13 patients (3.43%). The only identified risk factor was female sex (odds ratio 4.085). Isoniazid, rifampicin, pyrazinamide, and ethambutol were readministered in 11 patients and rifampicin was readministered in 2 patients, with 6- to 8-step protocols for each drug. Only in 2 patients did allergic reactions with rifampicin develop during the procedure. In these patients, after treatment and complete remission of allergic symptoms, the last tolerated dose was administered and the protocol was completed with the same adjustments.
  
  
  CONCLUSIONS
  Immediate-type allergic reactions from antituberculosis drugs are not rare and not related to disease or treatment characteristics. The protocols used in this study provide a useful and safe method for readministration of culprit drugs to patients with antituberculosis drug hypersensitivity.
authors.affiliation: Department of Immunology and Allergy, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey. Electronic address: gozdekoycu@gmail.com.
authors.forename: Gözde Köycü
authors.initials: GK
authors.lastname: Buhari
authors.affiliation: Department of Immunology and Allergy, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Keren
authors.affiliation: Department of Immunology and Allergy, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey; Division of Immunology and Allergy, Department of Internal Medicine, School of Medicine, Recep Tayyip Erdoğan University, Ankara, Turkey.
authors.forename: Adile Berna
authors.initials: AB
authors.lastname: Dursun
authors.affiliation: Department of Chest Diseases, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
authors.forename: Müjgan
authors.initials: M
authors.lastname: Güler
authors.affiliation: Department of Chest Diseases, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
authors.forename: Güngör
authors.initials: G
authors.lastname: Dulkar
authors.affiliation: Department of Chest Diseases, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
authors.forename: Nilgün
authors.initials: N
authors.lastname: Kalaç
authors.affiliation: Department of Chest Diseases, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
authors.forename: Şeref
authors.initials: Ş
authors.lastname: Özkara
authors.affiliation: Department of Immunology and Allergy, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
authors.forename: Ferda Öner
authors.initials: FÖ
authors.lastname: Erkekol
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D003888:Desensitization, Immunologic; D004334:Drug Administration Schedule; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005483:Flushing / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D015995:Prevalence; D011537:Pruritus / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D012737:Sex Factors; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy; D014581:Urticaria / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000305:Adrenal Cortex Hormones; D000995:Antitubercular Agents; D006633:Histamine Antagonists