Rosário Nelson A, Grumach Anete Sevciovic
Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
J Pediatr (Rio J). 2006 Nov;82(5 Suppl):S181-8. doi: 10.2223/JPED.1558.
To present a practical approach to the diagnosis and management of allergy to beta-lactam antibiotics.
Allergy journals indexed in MEDLINE and LILACS, as well as seminal studies and texts.
Allergy to penicillin is commonly reported. In many cases, this results in the decision not to use this drug. About 10% of drug allergy reports are confirmed. The clinical manifestations due to allergic reaction to penicillin vary widely, with emphasis on skin disorders. Gell & Coombs' four hypersensitivity mechanisms are involved in allergic reactions. Penicillin is degraded to a major (95%) and minor determinants (5%). Immediate IgE-mediated reactions causing anaphylaxis are associated with minor determinants in 95% of the cases. Hypersensitivity to these products can be assessed using cutaneous tests performed with major and minor determinants, thus avoiding anaphylactic shock in allergic individuals. The present article underscores the basic body of knowledge on allergy to penicillin, providing support for a more accurate diagnosis of this event and for the choice of management in cases of suspected beta-lactam allergy.
The incorrect diagnosis of penicillin allergy frequently leads to the exclusion of this drug as a therapeutic option. A better recognition of these situations will enable the use of penicillin and reduce the risks associated with hypersensitivity.
介绍一种诊断和管理β-内酰胺类抗生素过敏的实用方法。
MEDLINE和LILACS索引的过敏学期刊，以及开创性研究和文献。
青霉素过敏的报告很常见。在许多情况下，这导致决定不使用这种药物。约10%的药物过敏报告得到证实。青霉素过敏反应的临床表现差异很大，重点是皮肤疾病。Gell & Coombs的四种超敏反应机制参与过敏反应。青霉素降解为主要（95%）和次要决定簇（5%）。95%的病例中，导致过敏反应的即刻IgE介导反应与次要决定簇相关。对这些产品的超敏反应可以使用主要和次要决定簇进行皮肤试验来评估，从而避免过敏个体发生过敏性休克。本文强调了青霉素过敏的基础知识，为更准确地诊断该事件以及在疑似β-内酰胺类过敏的情况下选择管理方法提供支持。
青霉素过敏的错误诊断经常导致该药物被排除在治疗选择之外。更好地认识这些情况将使青霉素的使用成为可能，并降低与超敏反应相关的风险。
