Drug anaphylaxis incidence

Bronchospasm is not a direct action of these drugs but blockade of p-receptors increases the reactivity of the airway and increases the likelihood of bronchospasm during laryngoscopy and tracheal intubation. It is also possible that the severity, and possibly the incidence of acute anaphylaxis is increased in patients on large doses of 3 blockers and that resuscitation may be hampered in these circumstances. 

Procedure Beta-lactam desensitization should be done in an intensive care unit and any concomitant risk factors for anaphylaxis, such as use of beta-blockers should be corrected. Protocols based on incremental use of the drug orally or parenterally have been described (190,193). The oral route is preferable and is associated with a lower incidence of adverse events, but mild transient reactions are frequent (171,194,195). Pregnant women with limited antibiotic choices have been treated with immunotherapy (196). Repeated administration will maintain a state of anergy, which is often lost after withdrawal (197). At the conclusion of therapy, patients must be informed that after withdrawal, they may once again become allergic to penicillin, with a new reaction to the first subsequent application (197). 

The most serious hypersensitivity reactions produced by the penicillins are angioedema and anaphylaxis. Acute anaphylactic or anaphylactoid reactions to the penicillins constitute the most important immediate danger connected with their use. Among all drugs, the penicillins are most often responsible for this type of untoward effect. Anaphylactoid reactions to penicillins may occur at any age their incidence is thought to be 0.004-0.04%. About 0.001% of patients treated with these agents die from anaphylaxis. Anaphylaxis most often has followed parenteral use but also has been observed after oral or intradermal administration. The most dramatic reaction is sudden hypotension and death. In other instances, bronchoconstriction with severe asthma abdominal pain, nausea, and vomiting extreme weakness or diarrhea and purpuric skin eruptions have characterized the anaphylactic episodes. 

Toxicity No cytokine-release syndrome has been observed with these antibodies, but anaphylaxis can occur. Although lymphoproliferative disorders and opportunistic infections may occur, the incidence ascribed to anti-CD25 treatment is remarkably low. No significant drug interactions with anti-IL-2-receptor antibodies have been described. 

Benveniste J (1974) Platelet-activating factor, a new mediator of anaphylaxis and immune complex deposition from rabbit and human basophils. Nature 249 581 Berkowitz M, Glaser J, Johnstone DE (1953) The incidence of allergy to drugs in pediatric practice. Ann Allergy 11 561... 

It seems that every new drug administered to humans has the potential to provoke an anaphylactic response, and the likelihood of such a response therefore increases with inaeased administration. Unformnately, while the signs and symptoms of what is commonly termed anaphylactic shock seem clear enough, incidences of anaphylaxis in different countries and to different drugs, as well as the terminology used for reactions is often far from consistent. 

The incidence of all causes of anaphylaxis in Western countries is estimated to be from about 8 to 50 per 100,000 persons per year with 3-4 % hospitalized and a lifetime prevalence of 0.05-2 %. In one retrospective Danish study of anaphylaxis over a 13-year period outside hospital in a catchment area of 48,000 subjects, an incidence of 3.2 cases per 100,000 persons per year was found. Of the 20 cases of anaphylaxis identified, seven were provoked by oral penicillin and three by oral aspirin, indicating that anaphylaxis to penicillin in the non-hospital environment was more common than thought. A retrospective population-based cohort study of 1,255 US residents in one county over a 5-year period revealed an incidence of anaphylaxis of 30 per 100,000 persons per year with an average annual incidence rate of 21 per 100,000 person-years. Drugs, along with foods and insect stings, were the main causes. In a prospective study of 432 Australian patients, medication was the cause in 8.3 % of cases. Minimum occurrence and incidence of new cases were estimated to be 12.6 and 9.9 episodes per 100,000 patient-years,... 

Incidences of Drug- and Other Agent-Induced Anaphylaxis During Anesthesia... 

According to a 2007 analysis of apiotinin-induced anaphylaxis in over 12,000 patients exposed to the drug in cardiac surgery, the incidences of hypersensitivity reactions were 4.1 %,... 

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