NEW YORK (Reuters Health) - Antibiotic desensitization is a useful option for the “challenging scenario” of treating patients infected with bacterial organisms that are sensitive only to antibiotics to which the patient is allergic, researchers report.
“Rather than denying these patients potentially life-saving therapy, antibiotic desensitization should be considered,” Dr. Stuart E. Turvey, of Children’s Hospital in Boston, told Reuters Health. “Desensitization allows safe delivery of an antibiotic to a patient who has an IgE-mediated sensitivity to that drug by administering it in small doses until the full therapeutic dose is clinically tolerated,” he said.
Dr. Turvey and colleagues reviewed the medical records of all 21 patients who underwent antibiotic desensitization at their institution during a 5-year period. Nineteen (90%) of the 21 patients had cystic fibrosis, which predisposed them to allergic sensitization to a wide range of antibiotics because they had received multiple courses of antibiotics over their lifetime.
A total of 57 desensitizations were performed encompassing 12 different antibiotics, with successful outcomes in 75%, Dr. Turvey’s team reports in the April Annals of Allergy, Asthma, & Immunology.
Of the 11 (19%) of antibiotic desensitization procedures that were terminated due to an allergic reaction, none were fatal or required intubation or other aggressive measures other than epinephrine, antihistamines, and corticosteroids. In 7 of the 11 failed desensitizations, a non-IgE mechanism was thought to be responsible for the allergic reaction.
According to Dr. Turvey, “this is the largest combined series of antibiotic desensitization outcomes published to date.” In their report, Dr. Turvey and colleagues detail how they select a candidate for antibiotic desensitization and present their standard successful protocols for desensitization for a range of common antibiotics used in patients with cystic fibrosis.
Source: Ann Allergy Asthma Immunol 2004;92:426-432. [ Google search on this article ]
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