Borish L, Tamir R, Rosenwasser L J
J Allergy Clin Immunol. 1987 Sep;80(3 Pt 1):314-9. doi: 10.1016/0091-6749(87)90037-6.
Patients allergic to penicillin (PCN) often require treatment with beta-lactam antibiotics for life-threatening bacterial infections. In this article, we review our experience with rapid intravenous desensitization for patients who gave a history of PCN allergy and who had hypersensitivity demonstrated by skin tests. Skin testing was performed with both prick and intradermal techniques and with the recommended antibiotic as well as PCN G, penicilloyl polylysine, and a minor determinant mixture. Patients were transferred to the intensive care unit, and desensitization was performed with a buret technique that required minimal preparation and was easily applied to any antibiotic. Fifteen desensitizations in 12 patients were associated with no immediate reactions. One patient developed a delayed reaction consisting of a pruritic rash and angioedema. A second patient developed a more serious delayed serum sickness-like illness with fever, rash, eosinophilia, abnormal liver function tests, and urinary abnormalities. These reactions did not necessitate stopping the antibiotic, although the latter patient required corticosteroids to suppress his symptoms. Rapid intravenous desensitization is a rapid, safe, and effective technique for patients demonstrating hypersensitivity to beta-lactam antibiotics who require therapy with these medications.
对青霉素（PCN）过敏的患者在发生危及生命的细菌感染时，常常需要使用β-内酰胺类抗生素进行治疗。在本文中，我们回顾了对有PCN过敏史且皮肤试验显示过敏的患者进行快速静脉脱敏治疗的经验。采用点刺和皮内技术，使用推荐的抗生素以及青霉素G、青霉噻唑聚赖氨酸和次要决定簇混合物进行皮肤试验。患者被转入重症监护病房，采用滴定管技术进行脱敏治疗，该技术所需准备工作极少，且易于应用于任何抗生素。12例患者进行的15次脱敏治疗均未出现即刻反应。1例患者出现延迟反应，表现为瘙痒性皮疹和血管性水肿。另1例患者出现更严重的延迟性血清病样疾病，伴有发热、皮疹、嗜酸性粒细胞增多、肝功能检查异常和尿液异常。尽管后1例患者需要使用糖皮质激素来缓解症状，但这些反应并未导致抗生素停用。对于对β-内酰胺类抗生素过敏但需要使用此类药物进行治疗的患者，快速静脉脱敏是一种快速、安全且有效的技术。
