Lakhal Karim, Lortat-Jacob Brice, Neukirch Catherine, Pajot Olivier, Wolff Michel
Services de Réanimation Médicale et Maladies Infectieuses, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France.
Pharmacotherapy. 2007 Sep;27(9):1334-8. doi: 10.1592/phco.27.9.1334.
Strong data are lacking on the cross-reactivity between individual carbapenems. We describe a 48-year-old woman with ventilator-associated Pseudomonas aeruginosa pneumonia who received an 8-day course of imipenem-cilastatin and experienced a delayed (i.e., nonimmediate) hypersensitivity reaction, evidenced by an extensive erythematous macular morbilliform rash and an increased eosinophil count. Eight days after completion of therapy, the pneumonia returned, and it was decided to avoid using imipenem-cilastatin; she was administered a 14-day course of meropenem. To our knowledge, this is the first report of a nonimmediate hypersensitivity reaction to imipenem-cilastatin without cross-reactivity to meropenem. This suggests that if carbapenem therapy is unavoidable, meropenem may be cautiously administered in patients with a known allergy to imipenem-cilastatin.
关于各个碳青霉烯类药物之间的交叉反应性，目前缺乏有力的数据。我们描述了一名48岁患有呼吸机相关性铜绿假单胞菌肺炎的女性，她接受了为期8天的亚胺培南 - 西司他丁治疗，并出现了延迟性（即非即刻性）超敏反应，表现为广泛的红斑性斑丘疹和嗜酸性粒细胞计数增加。治疗结束8天后，肺炎复发，决定避免使用亚胺培南 - 西司他丁；她接受了为期14天的美罗培南治疗。据我们所知，这是首例对亚胺培南 - 西司他丁发生非即刻性超敏反应且与美罗培南无交叉反应的报告。这表明，如果碳青霉烯类治疗不可避免，对于已知对亚胺培南 - 西司他丁过敏的患者，可以谨慎使用美罗培南。
