Sussman G L, Davis K, Kohler P F
CMAJ. 1986 Jun 15;134(12):1353-6.
Although penicillin is nontoxic, it is highly immunogenic and is the most common drug that causes allergic reactions. A previous reaction to penicillin has been shown to be unreliable in predicting sensitivity in 75% to 90% of patients. To more accurately test for penicillin allergy, diagnostic skin test reagents have been developed; these include the major determinant (benzylpenicilloyl-polylysine) and the minor determinant mixture (penicillin G potassium, benzylpenicilloate sodium and benzylpenicilloyl-N-propylamine). Penicillin skin testing has been shown to be safe and useful in predicting immediate IgE-mediated reactions (overall predictive value 99%). Reactions that occur when patients are challenged with penicillin are mild or accelerated urticarial reactions. We outline a practical and rational therapeutic approach based on the current understanding of penicillin allergy.
虽然青霉素无毒，但它具有高度免疫原性，是引起过敏反应最常见的药物。既往对青霉素的反应在预测75%至90%患者的敏感性方面已被证明不可靠。为了更准确地检测青霉素过敏，已开发出诊断性皮肤试验试剂；这些试剂包括主要决定簇（苄青霉素酰聚赖氨酸）和次要决定簇混合物（青霉素G钾、苄青霉素钠和苄青霉素酰-N-丙胺）。青霉素皮肤试验已被证明在预测即刻IgE介导的反应方面是安全且有用的（总体预测价值为99%）。患者使用青霉素激发试验时出现的反应为轻度或速发型荨麻疹反应。我们根据目前对青霉素过敏的认识概述了一种实用且合理的治疗方法。
