Amoxicillin allergic reaction

Vega JM, Blanca M, Carmona MJ, Garcia J, Claros A, Juarez C, Moya MC. Delayed allergic reactions to beta-lactams. Four cases with intolerance to amoxicillin or ampicillin and good tolerance to penicillin G and V. Allergy 1991 46(2) 154-7. 

Perez-Estrada M, Fernandez S, Acebes JM, Terrados S. Immediate allergic reactions to amoxicillin. Allergy 1994 49(5) 317-22. 189. 

A 7-year-old child presents with pharyngitis and fever of 2 days duration, and microbiology reveals small, translucent beta-hemolytic colonies sensitive in vitro to bacitracin. Past history includes a severe allergic reaction to amoxicillin when used for an ear infection. You need to treat this infection, but you prefer not to use a drug that needs parenteral administration. Which one of the following agents is most likely to be appropriate in terms of both effectiveness and safety ... 

The ciprofloxacin, doxycycline, or amoxicillin gave me an allergic reaction and I stopped taking it. What should I do ... 

Immunologic Allergic reactions to co-amoxiclav (amoxicillin-I-clavulanic acid) are not always due to the amoxicillin. Skin tests... 

Torres MJ, Ariza A, Femdndez J, Moreno E, Laguna JJ, Montanez MI, Ruiz-Sanchez AJ, Blanca M. Role of minor determinants of amoxicillin in the diagnosis of immediate allergic reactions to amoxicillin. Allergy 2010 65(5) 590-6. 

Immunologic The association of an allergic reaction with angina pectoris (the Kounis syndrome) has been discussed in the light of a case in which three episodes of vasospastic angina, two of them related to amoxicillin, could have been due to other causes [91, 92. Another case has been described in a 13-year-old boy, who developed chest pain 30 minutes after taking an oral dose of co-amoxiclav [93 ]. 

Allergic reactions to penicillins are usually of classes I and III, but class IV reactions can also occur, as illustrated by a reaction in a patient with systemic lupus erythematosus after the use of amoxicillin [94" ]. 

Pseudoallergic reactions resemble allergic reactions clinically but are not immunologically mediated. Examples include asthma and rashes caused by aspirin and maculopapular erythematous rashes due to ampicillin or amoxicillin in the absence of penicillin hypersensitivity. Few other entities that can initiate this reaction are sulfonamides, anticonvulsants (phenytoin, carbamazepine and phenobarbital), NSAIDs (aspirin, naproxen, nabumetone and keto-profen), antiretroviral agents and cephalosporins [1 ]. 

The question of tolerability of penicillins, monobactams, and carbapenems in patients with IgE hypersensitivity to cephalosporins was recently assessed in 98 subjects by serum IgE antibody assays, challenge tests, and skin testing with penicillin reagents, aztreonam, imipenem-cilastatin, and meropenem. Approximately 25 % of cephalosporin-allergic subjects were positive to penicillins, while 3.1,2, and 1 % showed positive results to aztreonam, imipenem, and meropenem, respectively. A reaction to a cephalosporin with a similar or identical side chain to penicillin was a sigifificant predictor of cross-reactivity. For skin testing, the following concentrations were used ampicillin and amoxicillin 1 and 20 mg/ml cephalosporins 2 mg/ml aztreonam 2 mg/ml imipenem-cilastatin 0.5 mg/ml and meropenem 1 mg/ml. 

In an evaluation of 276 patients who had a reaction attributed to amoxicUlin-clavulanic acid, 55 patients (19.9 %) reacted positively to different penicillin determinants. Of the 221 with negative skin tests, 15 were positive to amoxicillin and seven were judged to be allergic to clavulanic acid on the basis of tolerance to benzylpenicillin and amoxicillin and an immediate reaction to clavulanic acid following challenges. In the skin test-positive group, skin and... 

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