Amsler E, Soria A
Service de dermatologie et allergologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
Service de dermatologie et allergologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Inserm U1135, immunology and infectious diseases center-Paris (Cimi-Paris), Sorbonne université, UPMC université Paris 06, 75013 Paris, France.
Rev Med Interne. 2017 Nov;38(11):737-748. doi: 10.1016/j.revmed.2017.06.020. Epub 2017 Jul 25.
Allergy to beta-lactam antibiotics is a common condition and about 10% of patients report being allergic to penicillin. However, this diagnosis is largely overestimated. Two types of allergy should be distinguished and include immediate hypersensitivity that can lead to anaphylactic shock and delayed hypersensitivity, ranging from the most common maculopapular exanthema to severe bullous toxidermia or life-threatening DRESS. Allergy challenge with oriented skin tests according to the clinical features, supplemented with oral challenge in the absence of contraindication, will confirm or invalidate the diagnosis of beta-lactam allergy and will help to identify if necessary safe alternatives to beta-lactams.
对β-内酰胺类抗生素过敏是一种常见情况，约10%的患者报告对青霉素过敏。然而，这种诊断在很大程度上被高估了。应区分两种类型的过敏，包括可导致过敏性休克的速发型超敏反应和迟发型超敏反应，范围从最常见的斑丘疹性皮疹到严重的大疱性中毒性表皮坏死松解症或危及生命的药物超敏反应综合征。根据临床特征进行有针对性的皮肤试验，并在无禁忌证的情况下辅以口服激发试验，将证实或排除β-内酰胺类过敏的诊断，并在必要时有助于确定β-内酰胺类药物的安全替代药物。
