Penicilloyl-polylysine

Green GR, Rosenblum AH, Sweet LC. Evaluation of penicillin hypersensitivity value of clinical history and skin testing with penicilloyl-polylysine and penicillin G. A cooperative prospective study of the penicillin study group of the American Academy of Allergy. J Allergy Clin Immunol 1977 60(6) 339-45. 

Penicillins, which are the safest of antibiotics, produce few direct toxic reactions, and most of the serious side effects are hypersensitivity reactions. Penicillins and their by-products, penicilloic acid and penicilloyl polylysine, are antigenic in susceptible individuals who develop immunoglobulin G... 

The polymers isolated from ampicillin and benzylpenicillin solutions have further been shown to give wheal and flare reactions in a number of penicillin allergic patients, all of whom have given skin reactions also to a penicilloyl-polylysine conjugate (JuHLiN et al. 1977). Finally, a limited clinical study by Parker and Richmond (1976) has indicated that the use of so-called polymer-free ampicillin may reduce the incidence of certain exanthematic adverse reactions to ampicillin preparations. 

Intracutaneous tests, scratch tests, and prick tests can be performed with the drugs as such or with their conjugates, for example penicilloyl-polylysine. Type I reactions are the main field of usefulness, but the tests are also suitable for demon-... 

Results as shown in Table 5 demonstrate that testing with penicilloyl-polylysine yields a high percentage of positive skin tests in the early stage following the reaction, whereas results obtained with benzylpenicillin (BPN) are much lower, which sems to demonstrate that different determinants are involved. This is confirmed by the observation that onyl one-third of these patients react positively to both reagents. 

Brogard JM, Bergoend H, Basset A (1969) Tolerance du traitement par la cephaloridine. Etude Clinique et application du test de Shelley aux recherches de sensibilisation croisee entre penicilline et cephaloridine. Nouv Presse Med 77 1539 Brooks AP (1974) Thrombocytopenia during treatment with ampicillin. Lancet 2 723 Brown BC, Price EV, Moore MB (1964) Penicilloyl-polylysine as an intradermal test of penicillin sensitivity. JAMA 189 599... 

Fernstrom AIB (1962) Studies on procaine allergy with reference to urticaria due to procaine penicillin treatment. Acta Derm Venerol 42 79 Fessel WJ (1972) Immunologic reactions in hyperuricemia. N Engl J Med 286 1218 Finke SR, Grieco MH, Connell JT, Smith EC, Sherman W (1965) Results of comparative skin tests with penicilloyl-polylysine and penidllin in patients with penicillin allergy. Am J Med 38 71... 

Parker CW, Thiel JA (1963) Studies in human penicillin allergy a comparison of various penicilloyl-polylysines. J Lab Clin Med 62 482 Parker CW, de Week AL, Kern M, Eisen HN (1962 a) The preparation and some properties of penicillenic acid derivatives relevant to penicillin hypersensitivity. J Exp Med 115 803 Parker CW, Shapiro J, Kern M, Eisen HN (1962 b) Hypersensitivity to penicillenic acid de-rivates in human beings with penicillin allergy. J Exp Med 115 821 Parry MF, Ball WD, Conde JE Jr (1963) Nafcillin nephritis. JAMA 225 178 Patel BM (1967) Skin rashes with infectious mononucleosis and ampicillin. Pediatrics 40 910... 

Immunologic The contribution of skin tests with penicilloyl-polylysine and the minor determinant mixture to the diagnosis of non-immediate reactions to penicillins have been evaluated in 162 adults who had had 232 non-immediate reactions to penicillins, mostly aminopenicillins, and had positive skin and/or patch tests to one or more penicillin reagents penicilloyl-polylysine,... 

In a retrospective review of 1068 patients with a self-reported history of beta-lactam allergy who had skin tests with penicilloyl— polylysine, penicillin G, penicilloate, penilloate, and amoxicillin, 243 (23%) had a positive reaction and testing with amoxicillin was positive in 31% of those 14 of the 243 positive patients (5.8%) had a positive skin tests only to amoxicillin [39 ]. 

Romano A, Gaeta F, Valluzzi RL, Caruso C, Rumi G, Bousquet PJ. The very limited usefulness of skin testing with penicilloyl-polylysine and the minor determinant mixture in evaluating nonimmediate reactions to penicillins. Allergy 2010 65(9) 1104-7. 

The usefulness of the penicillin major and minor determinants in evaluating delayed reactions to penicillins was assessed in intradermal and patch tests on 162 patients who experienced delayed reactions to penicillins, mainly aminopenicillins. Positive intradermal and/or patch tests in 157 patients (96.9 %) to the responsible penicillin reagents indicated cell-mediated hypersensitivity while only 9 (5.5 %) and 17 (10.5 %) were positive to penicilloyl-polylysine and minor determinant mix, respectively, demonstrating the limited usefulness of the two benzylpenicillin determinant preparations. 

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