Allergy Asthma Immunol Res.  2010 Apr;2(2):77-86. 10.4168/aair.2010.2.2.77.

Update on the Management of Antibiotic Allergy

• Thong BY

• KMID: 2260593
• DOI: http://doi.org/10.4168/aair.2010.2.2.77

Abstract

Drug allergy to antibiotics may occur in the form of immediate or non-immediate (delayed) hypersensitivity reactions. Immediate reactions are usually IgE-mediated whereas non-immediate hypersensitivity reactions are usually non-IgE or T-cell mediated. The clinical manifestations of antibiotic allergy may be cutaneous, organ-specific (e.g., blood dyscracias, hepatitis, interstitial nephritis), systemic (e.g., anaphylaxis, drug induced hypersensitivity syndrome) or various combinations of these. Severe cutaneous adverse reactions manifesting as Stevens Johnson syndrome or toxic epidermal necrolysis (TEN) may be potentially life-threatening. The management of antibiotic allergy begins with the identification of the putative antibiotic from a detailed and accurate drug history, complemented by validated in-vivo and in-vitro allergological tests. This will facilitate avoidance of the putative antibiotic through patient education, use of drug alert cards, and electronic medical records with in-built drug allergy/adverse drug reaction prescription and dispensing checks. Knowledge of the evidence for specific antibiotic cross-reactivities is also important in patient education. Apart from withdrawal of the putative antibiotic, immunomodulatory agents like high-dose intravenous immunoglobulins may have a role in TEN. Drug desensitization where the benefits outweigh the risks, and where no alternative antibiotics can be used for various reasons, may be considered in certain situations. Allergological issues pertaining to electronic drug allergy alerts, computerized physician prescriptions and decision support systems, and antibiotic de-escalation in antimicrobial stewardship programmes are also discussed.

Keyword

Anaphylaxis; desensitization; drug hypersensitivity; Stevens Johnson syndrome; toxic epidermal necrolysis

MeSH Terms

Anaphylaxis
Anti-Bacterial Agents
Complement System Proteins
Drug Hypersensitivity
Electronic Health Records
Electronics
Electrons
Epidermal Necrolysis, Toxic
Hepatitis
Hypersensitivity
Immunoglobulins, Intravenous
Patient Education as Topic
Prescriptions
Stevens-Johnson Syndrome
T-Lymphocytes
Anti-Bacterial Agents
Complement System Proteins
Immunoglobulins, Intravenous

Reference

1. Cars O, Molstad S, Melander A. Variation in antibiotic use in the European Union. Lancet. 2001. 357:1851–1853.

2. McCaig LF, Hughes JM. Trends in antimicrobial drug prescribing among office-based physicians in the United States. JAMA. 1995. 273:214–219.

3. Bigby M, Jick S, Jick H, Arndt K. Drug-induced cutaneous reactions. A report from the Boston Collaborative Drug Surveillance Program on 15,438 consecutive inpatients, 1975 to 1982. JAMA. 1986. 256:3358–3363.

4. Rademaker M, Oakley A, Duffill MB. Cutaneous adverse drug reactions in a hospital setting. N Z Med J. 1995. 108:165–166.

5. Hunziker T, Kunzi UP, Braunschweig S, Zehnder D, Hoigne R. Comprehensive hospital drug monitoring (CHDM): adverse skin reactions, a 20-year survey. Allergy. 1997. 52:388–393.

6. Thong BY, Leong KP, Tang CY, Chng HH. Drug allergy in a general hospital: Results of a novel prospective inpatient reporting system. Ann Allergy Asthma Immunol. 2003. 90:342–347.

7. Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, Motala C, Ortega Martell JA, Platts-Mills TA, Ring J, Thien F, Van Cauwenberge P, Williams HC. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol. 2004. 113:832–836.

8. Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. Arch Dermatol. 1993. 129:92–96.

9. Demoly P, Kropf R, Bircher A, Pichler WJ. Drug hypersensitivity: questionnaire. EAACI interest group on drug hypersensitivity. Allergy. 1999. 54:999–1003.

10. Park CS, Kim TB, Kim SL, Kim JY, Yang KA, Bae YJ, Cho YS, Moon HB. The use of an electronic medical record system for mandatory reporting of drug hypersensitivity reactions has been shown to improve the management of patients in the university hospital in Korea. Pharmacoepidemiol Drug Saf. 2008. 17:919–925.

11. Mann T, Colven R. A picture is worth more than a thousand words: enhancement of a pre-exam telephone consultation in dermatology with digital images. Acad Med. 2002. 77:742–743.

12. Leggett P, Gilliland AE, Cupples ME, McGlade K, Corbett R, Stevenson M, O'Reilly D, Steele K. A randomized controlled trial using instant photography to diagnose and manage dermatology referrals. Fam Pract. 2004. 21:54–56.

13. Eminovic N, de Keizer NF, Wyatt JC, ter Riet G, Peek N, van Weert HC, Bruijnzeel-Koomen CA, Bindels PJ. Teledermatologic consultation and reduction in referrals to dermatologists: a cluster randomized controlled trial. Arch Dermatol. 2009. 145:558–564.

14. Position paper: Allergen standardization and skin tests. The European Academy of Allergology and Clinical Immunology. Allergy. 1993. 48:48–82.

15. Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy. 2002. 57:45–51.

16. Edwards RG, Spackman DA, Dewdney JM. Development and use of three new radioallergosorbent tests in the diagnosis of penicillin allergy. Int Arch Allergy Appl Immunol. 1982. 68:352–357.

17. Garcia JJ, Blanca M, Moreno F, Vega JM, Mayorga C, Fernandez J, Juarez C, Romano A, de Ramon E. Determination of IgE antibodies to the benzylpenicilloyl determinant: a comparison of the sensitivity and specificity of three radio allergo sorbent test methods. J Clin Lab Anal. 1997. 11:251–257.

18. Hausmann OV, Gentinetta T, Bridts CH, Ebo DG. The basophil activation test in immediate-type drug allergy. Immunol Allergy Clin North Am. 2009. 29:555–566.

19. Barbaud A. Skin testing in delayed reactions to drugs. Immunol Allergy Clin North Am. 2009. 29:517–535.

20. Barbaud A, Goncalo M, Bruynzeel D, Bircher A. Guidelines for performing skin tests with drugs in the investigation of cutaneous adverse drug reactions. Contact Dermatitis. 2001. 45:321–328.

21. Pichler WJ, Tilch J. The lymphocyte transformation test in the diagnosis of drug hypersensitivity. Allergy. 2004. 59:809–820.

22. Lochmatter P, Zawodniak A, Pichler WJ. In vitro tests in drug hypersensitivity diagnosis. Immunol Allergy Clin North Am. 2009. 29:537–554.

23. Aberer W, Bircher A, Romano A, Blanca M, Campi P, Fernandez J, Brockow K, Pichler WJ, Demoly P. Drug provocation testing in the diagnosis of drug hypersensitivity reactions: general considerations. Allergy. 2003. 58:854–863.

24. Nizankowska-Mogilnicka E, Bochenek G, Mastalerz L, Swierczynska M, Picado C, Scadding G, Kowalski ML, Setkowicz M, Ring J, Brockow K, Bachert C, Wohrl S, Dahlen B, Szczeklik A. EAACI/GA2LEN guideline: aspirin provocation tests for diagnosis of aspirin hypersensitivity. Allergy. 2007. 62:1111–1118.

25. Patterson R, DeSwarte RD, Greenberger PA, Grammer LC, Brown JE, Choy AC. Drug allergy and protocols for management of drug allergies. Allergy Proc. 1994. 15:239–264.

26. Patterson R, DeSwarte RD, Greenberger PA, Grammer LC. Drug allergy and protocols for management of drug allergies. N Engl Reg Allergy Proc. 1986. 7:325–342.

27. Executive summary of disease management of drug hypersensitivity: a practice parameter. Joint Task Force on Practice Parameters, the American Academy of Allergy, Asthma and Immunology, the American Academy of Allergy, Asthma and Immunology, and the Joint Council of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol. 1999. 83:665–700.

28. Messaad D, Sahla H, Benahmed S, Godard P, Bousquet J, Demoly P. Drug provocation tests in patients with a history suggesting an immediate drug hypersensitivity reaction. Ann Intern Med. 2004. 140:1001–1006.

29. Castells M. Rapid desensitization for hypersensitivity reactions to medications. Immunol Allergy Clin North Am. 2009. 29:585–606.

30. Torres MJ, Blanca M, Fernandez J, Romano A, Weck A, Aberer W, Brockow K, Pichler WJ, Demoly P. Diagnosis of immediate allergic reactions to beta-lactam antibiotics. Allergy. 2003. 58:961–972.

31. Bousquet PJ, Co-Minh HB, Arnoux B, Daures JP, Demoly P. Importanceof mixture of minor determinants and benzylpenicilloyl poly-L-lysine skin testing in the diagnosis of beta-lactam allergy. J Allergy Clin Immunol. 2005. 115:1314–1316.

32. Romano A, Viola M, Bousquet PJ, Gaeta F, Valluzzi R, Caruso C, Demoly P. A comparison of the performance of two penicillin reagent kits in the diagnosis of beta-lactam hypersensitivity. Allergy. 2007. 62:53–58.

33. Matheu V, Perez E, Gonzalez R, Poza P, de la Torre F, Sanchez-Machin I, Garcia-Robaina JC. Assessment of a new brand of determinants for skin testing in a large group of patients with suspected beta-lactam allergy. J Investig Allergol Clin Immunol. 2007. 17:257–260.

34. Romano A, Bousquet-Rouanet L, Viola M, Gaeta F, Demoly P, Bousquet PJ. Benzylpenicillin skin testing is still important in diagnosing immediate hypersensitivity reactions to penicillins. Allergy. 2009. 64:249–253.

35. Blanca M, Mayorga C, Torres MJ, Reche M, Moya MC, Rodriguez JL, Romano A, Juarez C. Clinical evaluation of Pharmacia CAP System RAST FEIA amoxicilloyl and benzylpenicilloyl in patients with penicillin allergy. Allergy. 2001. 56:862–870.

36. Blanca M, Mayorga C, Perez E, Suau R, Juarez C, Vega JM, Carmona MJ, Perez-Estrada M, Garcia J. Determination of IgE antibodies to the benzyl penicilloyl determinant. A comparison between poly-L-lysine and human serum albumin as carriers. J Immunol Methods. 1992. 153:99–105.

37. Sanz ML, Gamboa PM, Antepara I, Uasuf C, Vila L, Garcia-Aviles C, Chazot M, De Weck AL. Flow cytometric basophil activation test by detection of CD63 expression in patients with immediate-type reactions to betalactam antibiotics. Clin Exp Allergy. 2002. 32:277–286.

38. Torres MJ, Padial A, Mayorga C, Fernandez T, Sanchez-Sabate E, Cornejo-Garcia JA, Antunez C, Blanca M. The diagnostic interpretation of basophil activation test in immediate allergic reactions to betalactams. Clin Exp Allergy. 2004. 34:1768–1775.

39. Fernandez TD, Torres MJ, Blanca-Lopez N, Rodriguez-Bada JL, Gomez E, Canto G, Mayorga C, Blanca M. Negativization rates of IgE radioimmunoassay and basophil activation test in immediate reactions to penicillins. Allergy. 2009. 64:242–248.

40. De Week AL, Sanz ML, Gamboa PM, Aberer W, Sturm G, Bilo MB, Montroni M, Blanca M, Torres MJ, Mayorga L, Campi P, Manfredi M, Drouet M, Sainte-Laudy J, Romano A, Merk H, Weber JM, Jermann TM. Diagnosis of immediate-type beta-lactam allergy in vitro by flow-cytometric basophil activation test and sulfidoleukotriene production: a multicenter study. J Investig Allergol Clin Immunol. 2009. 19:91–109.

41. Abuaf N, Rostane H, Rajoely B, Gaouar H, Autegarden JE, Leynadier F, Girot R. Comparison of two basophil activation markers CD63 and CD203c in the diagnosis of amoxicillin allergy. Clin Exp Allergy. 2008. 38:921–928.

42. Romano A, Blanca M, Torres MJ, Bircher A, Aberer W, Brockow K, Pichler WJ, Demoly P. Diagnosis of nonimmediate reactions to beta-lactam antibiotics. Allergy. 2004. 59:1153–1160.

43. Dash CH. Penicillin allergy and the cephalosporins. J Antimicrob Chemother. 1975. 1:107–118.

44. Saxon A, Beall GN, Rohr AS, Adelman DC. Immediate hypersensitivity reactions to beta-lactam antibiotics. Ann Intern Med. 1987. 107:204–215.

45. Kelkar PS, Li JT. Cephalosporin allergy. N Engl J Med. 2001. 345:804–809.

46. Mirakian R, Ewan PW, Durham SR, Youlten LJ, Dugue P, Friedmann PS, English JS, Huber PA, Nasser SM. BSACI guidelines for the management of drug allergy. Clin Exp Allergy. 2009. 39:43–61.

47. Perez-Inestrosa E, Suau R, Montanez MI, Rodriguez R, Mayorga C, Torres MJ, Blanca M. Cephalosporin chemical reactivity and its immunological implications. Curr Opin Allergy Clin Immunol. 2005. 5:323–330.

48. Antunez C, Blanca-Lopez N, Torres MJ, Mayorga C, Perez-Inestrosa E, Montanez MI, Fernandez T, Blanca M. Immediate allergic reactions to cephalosporins: evaluation of cross-reactivity with a panel of penicillins and cephalosporins. J Allergy Clin Immunol. 2006. 117:404–410.

49. Saxon A, Adelman DC, Patel A, Hajdu R, Calandra GB. Imipenem cross-reactivity with penicillin in humans. J Allergy Clin Immunol. 1988. 82:213–217.

50. Romano A, Viola M, Gueant-Rodriguez RM, Gaeta F, Pettinato R, Gueant JL. Imipenem in patients with immediate hypersensitivity to penicillins. N Engl J Med. 2006. 354:2835–2837.

51. Romano A, Viola M, Gueant-Rodriguez RM, Gaeta F, Valluzzi R, Gueant JL. Brief communication: tolerability of meropenem in patients with IgE-mediated hypersensitivity to penicillins. Ann Intern Med. 2007. 146:266–269.

52. Atanaskovic-Markovic M, Gaeta F, Medjo B, Viola M, Nestorovic B, Romano A. Tolerability of meropenem in children with IgE-mediated hypersensitivity to penicillins. Allergy. 2008. 63:237–240.

53. Schiavino D, Nucera E, Lombardo C, Decinti M, Pascolini L, Altomonte G, Buonomo A, Patriarca G. Cross-reactivity and tolerability of imipenem in patients with delayed-type, cell-mediated hypersensitivity to beta-lactams. Allergy. 2009. 64:1644–1648.

54. Mockenhaupt M, Viboud C, Dunant A, Naldi L, Halevy S, Bouwes Bavinck JN, Sidoroff A, Schneck J, Roujeau JC, Flahault A. Stevens-Johnson syndrome and toxic epidermal necrolysis: assessment of medication risks with emphasis on recently marketed drugs. The EuroSCAR-study. J Invest Dermatol. 2008. 128:35–44.

55. Levi N, Bastuji-Garin S, Mockenhaupt M, Roujeau JC, Flahault A, Kelly JP, Martin E, Kaufman DW, Maison P. Medications as risk factors of Stevens-Johnson syndrome and toxic epidermal necrolysis in children: a pooled analysis. Pediatrics. 2009. 123:e297–e304.

56. Ryan C, Madalon M, Wortham DW, Graziano FM. Sulfa hypersensitivity in patients with HIV infection: onset, treatment, critical review of the literature. WMJ. 1998. 97:23–27.

57. O'Neil WM, MacArthur RD, Farrough MJ, Doll MA, Fretland AJ, Hein DW, Crane LR, Svensson CK. Acetylator phenotype and genotype in HIV-infected patients with and without sulfonamide hypersensitivity. J Clin Pharmacol. 2002. 42:613–619.

58. Pirmohamed M, Alfirevic A, Vilar J, Stalford A, Wilkins EG, Sim E, Park BK. Association analysis of drug metabolizing enzyme gene polymorphisms in HIV-positive patients with co-trimoxazole hypersensitivity. Pharmacogenetics. 2000. 10:705–713.

59. Alfirevic A, Vilar FJ, Alsbou M, Jawaid A, Thomson W, Ollier WE, Bowman CE, Delrieu O, Park BK, Pirmohamed M. TNF, LTA, HSPA1L and HLA-DR gene polymorphisms in HIV-positive patients with hypersensitivity to cotrimoxazole. Pharmacogenomics. 2009. 10:531–540.

60. Lin D, Li WK, Rieder MJ. Cotrimoxazole for prophylaxis or treatment of opportunistic infections of HIV/AIDS in patients with previous history of hypersensitivity to cotrimoxazole. Cochrane Database Syst Rev. 2007. CD005646.

61. Schmid DA, Campi P, Pichler WJ. Hypersensitivity reactions to quinolones. Curr Pharm Des. 2006. 12:3313–3326.

62. Gonzalez I, Lobera T, Blasco A, del Pozo MD. Immediate hypersensitivity to quinolones: moxifloxacin cross-reactivity. J Investig Allergol Clin Immunol. 2005. 15:146–149.

63. Seitz CS, Brocker EB, Trautmann A. Diagnostic testing in suspected fluoroquinolone hypersensitivity. Clin Exp Allergy. 2009. 39:1738–1745.

64. Venturini Diaz M, Lobera Labairu T, del Pozo Gil MD, Blasco Sarramian A, Gonzalez Mahave I. In vivo diagnostic tests in adverse reactions to quinolones. J Investig Allergol Clin Immunol. 2007. 17:393–398.

65. Schmid DA, Depta JP, Pichler WJ. T cell-mediated hypersensitivity to quinolones: mechanisms and cross-reactivity. Clin Exp Allergy. 2006. 36:59–69.

66. Araujo L, Demoly P. Macrolides allergy. Curr Pharm Des. 2008. 14:2840–2862.

67. Pascual C, Crespo JF, Quiralte J, Lopez C, Wheeler G, Martin-Esteban M. In vitro detection of specific IgE antibodies to erythromycin. J Allergy Clin Immunol. 1995. 95:668–671.

68. Holmes NE, Hodgkinson M, Dendle C, Korman TM. Report of oral clarithromycin desensitization. Br J Clin Pharmacol. 2008. 66:323–324.

69. Shapiro LE, Knowles SR, Shear NH. Comparative safety of tetracycline, minocycline, and doxycycline. Arch Dermatol. 1997. 133:1224–1230.

70. Smith K, Leyden JJ. Safety of doxycycline and minocycline: a systematic review. Clin Ther. 2005. 27:1329–1342.

71. Lammintausta K, Tokola R, Kalimo K. Cutaneous adverse reactions to clindamycin: results of skin tests and oral exposure. Br J Dermatol. 2002. 146:643–648.

72. Mazur N, Greenberger PA, Regalado J. Clindamycin hypersensitivity appears to be rare. Ann Allergy Asthma Immunol. 1999. 82:443–445.

73. Sulewski RJ Jr, Blyumin M, Kerdel FA. Acute generalized exanthematous pustulosis due to clindamycin. Dermatol Online J. 2008. 14:14.

74. Paquet P, Schaaf-Lafontaine N, Pierard GE. Toxic epidermal necrolysis following clindamycin treatment. Br J Dermatol. 1995. 132:665–666.

75. Notman MJ, Phillips EJ, Knowles SR, Weber EA, Shear NH. Clindamycin skin testing has limited diagnostic potential. Contact Dermatitis. 2005. 53:335–338.

76. Seitz CS, Brocker EB, Trautmann A. Allergy diagnostic testing in clindamycin-induced skin reactions. Int Arch Allergy Immunol. 2009. 149:246–250.

77. Marcos C, Sopena B, Luna I, Gonzalez R, de la Fuente J, Martinez-Vazquez C. Clindamycin desensitization in an AIDS patient. AIDS. 1995. 9:1201–1202.

78. Martin JA, Alonso MD, Navas E, Antela A. [Clindamycin desensitization in a patient with the acquired immunodeficiency syndrome]. Med Clin (Barc). 1992. 98:478–479.

79. Svetitsky S, Leibovici L, Paul M. Comparative efficacy and safety of vancomycin versus teicoplanin: systematic review and meta-analysis. Antimicrob Agents Chemother. 2009. 53:4069–4079.

80. Chopra N, Oppenheimer J, Derimanov GS, Fine PL. Vancomycin anaphylaxis and successful desensitization in a patient with end stage renal disease on hemodialysis by maintaining steady antibiotic levels. Ann Allergy Asthma Immunol. 2000. 84:633–635.

81. Anne S, Middleton E Jr, Reisman RE. Vancomycin anaphylaxis and successful desensitization. Ann Allergy. 1994. 73:402–404.

82. Wazny LD, Daghigh B. Desensitization protocols for vancomycin hypersensitivity. Ann Pharmacother. 2001. 35:1458–1464.

83. Kitazawa T, Ota Y, Kada N, Morisawa Y, Yoshida A, Koike K, Kimura S. Successful vancomycin desensitization with a combination of rapid and slow infusion methods. Intern Med. 2006. 45:317–321.

84. Neughebauer BI, Negron G, Pelton S, Plunkett RW, Beutner EH, Magnussen R. Bullous skin disease: an unusual allergic reaction to vancomycin. Am J Med Sci. 2002. 323:273–278.

85. Waldman MA, Black DR, Callen JP. Vancomycin-induced linear IgA bullous disease presenting as toxic epidermal necrolysis. Clin Exp Dermatol. 2004. 29:633–636.

86. Polk RE. Anaphylactoid reactions to glycopeptide antibiotics. J Antimicrob Chemother. 1991. 27:Suppl B. 17–29.

87. Asero R. Teicoplanin-induced anaphylaxis. Allergy. 2006. 61:1370.

88. Unal S, Ikizoglu G, Demirkan F, Kaya TI. Teicoplanin-induced skin eruption. Int J Dermatol. 2002. 41:948–949.

89. Chu CY, Wu J, Jean SS, Sun CC. Acute generalized exanthematous pustulosis due to teicoplanin. Dermatology. 2001. 202:141–142.

90. Perrett CM, McBride SR. Teicoplanin induced drug hypersensitivity syndrome. BMJ. 2004. 328:1292.

91. Knudsen JD, Pedersen M. IgE-mediated reaction to vancomycin and teicoplanin after treatment with vancomycin. Scand J Infect Dis. 1992. 24:395–396.

92. McElrath MJ, Goldberg D, Neu HC. Allergic cross-reactivity of teicoplanin and vancomycin. Lancet. 1986. 1:47.

93. Marshall C, Street A, Galbraith K. Glycopeptide-induced vasculitis -cross-reactivity between vancomycin and teicoplanin. J Infect. 1998. 37:82–83.

94. Grek V, Andrien F, Collignon J, Fillet G. Allergic cross-reaction of teicoplanin and vancomycin. J Antimicrob Chemother. 1991. 28:476–477.

95. Kwon HS, Chang YS, Jeong YY, Lee SM, Song WJ, Kim HB, Kim YK, Cho SH, Kim YY, Min KU. A case of hypersensitivity syndrome to both vancomycin and teicoplanin. J Korean Med Sci. 2006. 21:1108–1110.

96. de Vries E, van Weel-Sipman MH, Vossen JM. A four-year-old child with teicoplanin allergy but no evidence of cross-reaction with vancomycin. Pediatr Infect Dis J. 1994. 13:167.

97. Macias E, Moreno E, Davila I, Laffond E, Ruiz A, Batista JC, Lorente F. Reaction to teicoplanin with tolerance to vancomycin. J Investig Allergol Clin Immunol. 2008. 18:71–72.

98. Park M, Markus P, Matesic D, Li JT. Safety and effectiveness of a preoperative allergy clinic in decreasing vancomycin use in patients with a history of penicillin allergy. Ann Allergy Asthma Immunol. 2006. 97:681–687.

99. Frigas E, Park MA, Narr BJ, Volcheck GW, Danielson DR, Markus PJ, Olson KE, Schroeder DR, Kita H. Preoperative evaluation of patients with history of allergy to penicillin: comparison of 2 models of practice. Mayo Clin Proc. 2008. 83:651–662.

100. Forget EJ, Menzies D. Adverse reactions to first-line antituberculosis drugs. Expert Opin Drug Saf. 2006. 5:231–249.

101. Lee AY, Jung SY. Two patients with isoniazid-induced photosensitive lichenoid eruptions confirmed by photopatch test. Photodermatol Photoimmunol Photomed. 1998. 14:77–78.

102. Leenutaphong V, Sivayathorn A, Suthipinittharm P, Sunthonpalin P. Stevens-Johnson syndrome and toxic epidermal necrolysis in Thailand. Int J Dermatol. 1993. 32:428–431.

103. Kuaban C, Bercion R, Koulla-Shiro S. HIV seroprevalence rate and incidence of adverse skin reactions in adults with pulmonary tuberculosis receiving thiacetazone free anti-tuberculosis treatment in Yaounde, Cameroon. East Afr Med J. 1997. 74:474–477.

104. Schreiber J, Zissel G, Greinert U, Schlaak M, Muller-Quernheim J. Lymphocyte transformation test for the evaluation of adverse effects of antituberculous drugs. Eur J Med Res. 1999. 4:67–71.

105. Yano S, Kobayashi K, Kato K, Tatsukawa T, Shishido S. [The usefulness of lymphocyte stimulation test (LST) in side effects of antituberculosis drugs]. Kekkaku. 2004. 79:7–10.

106. Suzuki Y, Miwa S, Shirai M, Ohba H, Murakami M, Fujita K, Suda T, Nakamura H, Hayakawa H, Chida K. Drug lymphocyte stimulation test in the diagnosis of adverse reactions to antituberculosis drugs. Chest. 2008. 134:1027–1032.

107. Kobashi Y, Okimoto N, Matsushima T, Abe T, Nishimura K, Shishido S, Kawahara S, Shigeto E, Takeyama H, Kuraoka T. [Desensitization therapy for allergic reactions of antituberculous drugs--evaluation of desensitization therapy according to the guideline of the Japanese Society for Tuberculosis]. Kekkaku. 2000. 75:699–704.

108. Holland CL, Malasky C, Ogunkoya A, Bielory L. Rapid oral desensitization to isoniazid and rifampin. Chest. 1990. 98:1518–1519.

109. Matz J, Borish LC, Routes JM, Rosenwasser LJ. Oral desensitization to rifampin and ethambutol in mycobacterial disease. Am J Respir Crit Care Med. 1994. 149:815–817.

110. Kim JH, Kim HB, Kim BS, Hong SJ. Rapid oral desensitization to isoniazid, rifampin, and ethambutol. Allergy. 2003. 58:540–541.

111. Buergin S, Scherer K, Hausermann P, Bircher AJ. Immediate hypersensitivity to rifampicin in 3 patients: diagnostic procedures and induction of clinical tolerance. Int Arch Allergy Immunol. 2006. 140:20–26.

112. Chung WH, Hung SI, Chen YT. Human leukocyte antigens and drug hypersensitivity. Curr Opin Allergy Clin Immunol. 2007. 7:317–323.

113. Shiohara T, Inaoka M, Kano Y. Drug-induced hypersensitivity syndrome (DIHS): a reaction induced by a complex interplay among herpesviruses and antiviral and antidrug immune responses. Allergol Int. 2006. 55:1–8.

114. Asano Y, Kagawa H, Kano Y, Shiohara T. Cytomegalovirus disease during severe drug eruptions: report of 2 cases and retrospective study of 18 patients with drug-induced hypersensitivity syndrome. Arch Dermatol. 2009. 145:1030–1036.

115. Aota N, Shiohara T. Viral connection between drug rashes and autoimmune diseases: how autoimmune responses are generated after resolution of drug rashes. Autoimmun Rev. 2009. 8:488–494.

116. Patterson R, Dykewicz MS, Gonzalzles A, Grammer LC, Green D, Greenberger PA, McGrath KG, Walker CL. Erythema multiforme and Stevens-Johnson syndrome. Descriptive and therapeutic controversy. Chest. 1990. 98:331–336.

117. Patterson R, Grammer LC, Greenberger PA, Lawrence ID, Zeiss CR, Detjen PF, Ganz MA, Miller TP, Orfan NA, Sonenthal KR, Stoloff RS. Stevens-Johnson syndrome (SJS): effectiveness of corticosteroids in management and recurrent SJS. Allergy Proc. 1992. 13:89–95.

118. Patterson R, Miller M, Kaplan M, Doan T, Brown J, Detjen P, Grammer LC, Greenberger PA, Hogan MB, Latall J, et al. Effectiveness of early therapy with corticosteroids in Stevens-Johnson syndrome: experience with 41 cases and a hypothesis regarding pathogenesis. Ann Allergy. 1994. 73:27–34.

119. Cheriyan S, Patterson R, Greenberger PA, Grammer LC, Latall J. The outcome of Stevens-Johnson syndrome treated with corticosteroids. Allergy Proc. 1995. 16:151–155.

120. Tripathi A, Ditto AM, Grammer LC, Greenberger PA, McGrath KG, Zeiss CR, Patterson R. Corticosteroid therapy in an additional 13 cases of Stevens-Johnson syndrome: a total series of 67 cases. Allergy Asthma Proc. 2000. 21:101–105.

121. Hynes AY, Kafkala C, Daoud YJ, Foster CS. Controversy in the use of high-dose systemic steroids in the acute care of patients with Stevens-Johnson syndrome. Int Ophthalmol Clin. 2005. 45:25–48.

122. Chave TA, Mortimer NJ, Sladden MJ, Hall AP, Hutchinson PE. Toxic epidermal necrolysis: current evidence, practical management and future directions. Br J Dermatol. 2005. 153:241–253.

123. Zaki I, Patel S, Reed R, Dalziel KL. Toxic epidermal necrolysis associated with severe hypocalcaemia, and treated with cyclosporin. Br J Dermatol. 1995. 133:337–338.

124. Jarrett P, Ha T, Snow J. Toxic epidermal necrolysis and cyclosporin. Clin Exp Dermatol. 1997. 22:254.

125. Sullivan JR, Watson A. Lamotrigine-induced toxic epidermal necrolysis treated with intravenous cyclosporin: a discussion of pathogenesis and immunosuppressive management. Australas J Dermatol. 1996. 37:208–212.

126. Wolkenstein P, Latarjet J, Roujeau JC, Duguet C, Boudeau S, Vaillant L, Maignan M, Schuhmacher MH, Milpied B, Pilorget A, Bocquet H, Brun-Buisson C, Revuz J. Randomised comparison of thalidomide versus placebo in toxic epidermal necrolysis. Lancet. 1998. 352:1586–1589.

127. Trautmann A, Klein CE, Kampgen E, Brocker EB. Severe bullous drug reactions treated successfully with cyclophosphamide. Br J Dermatol. 1998. 139:1127–1128.

128. Bamichas G, Natse T, Christidou F, Stangou M, Karagianni A, Koukourikos S, Chaidemenos G, Chrysomallis F, Sombolos K. Plasma exchange in patients with toxic epidermal necrolysis. Ther Apher. 2002. 6:225–228.

129. Stella M, Cassano P, Bollero D, Clemente A, Giorio G. Toxic epidermal necrolysis treated with intravenous high-dose immunoglobulins: our experience. Dermatology. 2001. 203:45–49.

130. Tristani-Firouzi P, Petersen MJ, Saffle JR, Morris SE, Zone JJ. Treatment of toxic epidermal necrolysis with intravenous immunoglobulin in children. J Am Acad Dermatol. 2002. 47:548–552.

131. Prins C, Kerdel FA, Padilla RS, Hunziker T, Chimenti S, Viard I, Mauri DN, Flynn K, Trent J, Margolis DJ, Saurat JH, French LE. Treatment of toxic epidermal necrolysis with high-dose intravenous immunoglobulins: multicenter retrospective analysis of 48 consecutive cases. Arch Dermatol. 2003. 139:26–32.

132. Trent JT, Kirsner RS, Romanelli P, Kerdel FA. Analysis of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis using SCORTEN: The University of Miami Experience. Arch Dermatol. 2003. 139:39–43.

133. Bachot N, Revuz J, Roujeau JC. Intravenous immunoglobulin treatment for Stevens-Johnson syndrome and toxic epidermal necrolysis: a prospective noncomparative study showing no benefit on mortality or progression. Arch Dermatol. 2003. 139:33–36.

134. Yip LW, Thong BY, Tan AW, Khin LW, Chng HH, Heng WJ. High-dose intravenous immunoglobulin in the treatment of toxic epidermal necrolysis: a study of ocular benefits. Eye (Lond). 2005. 19:846–853.

135. Shay E, Kheirkhah A, Liang L, Sheha H, Gregory DG, Tseng SC. Amniotic membrane transplantation as a new therapy for the acute ocular manifestations of Stevens-Johnson syndrome and toxic epidermal necrolysis. Surv Ophthalmol. 2009. 54:686–696.

136. Yang Y, Xu J, Li F, Zhu X. Combination therapy of intravenous immunoglobulin and corticosteroid in the treatment of toxic epidermal necrolysis and Stevens-Johnson syndrome: a retrospective comparative study in China. Int J Dermatol. 2009. 48:1122–1128.

137. Vedove CD, Del Giglio M, Schena D, Girolomoni G. Drug-induced lupus erythematosus. Arch Dermatol Res. 2009. 301:99–105.

138. Drew RH. Antimicrobial stewardship programs: how to start and steer a successful program. J Manag Care Pharm. 2009. 15:S18–S23.

139. Chazard E, Ficheur G, Merlin B, Serrot E, Beuscart R. Adverse drug events prevention rules: multi-site evaluation of rules from various sources. Stud Health Technol Inform. 2009. 148:102–111.

140. Abookire SA, Teich JM, Sandige H, Paterno MD, Martin MT, Kuperman GJ, Bates DW. Improving allergy alerting in a computerized physician order entry system. Proc AMIA Symp. 2000. 2–6.