Sogn D D
J Allergy Clin Immunol. 1984 Oct;74(4 Pt 2):589-93. doi: 10.1016/0091-6749(84)90111-8.
Although many new antibiotics are available, penicillin and its many semisynthetic derivatives are first-line drugs for many infections. These agents are relatively nontoxic even at high doses; however, their use frequently leads to allergic reactions. Withholding penicillin therapy from patients at high risk of allergic reaction to it is the most effective means of preventing such occurrences. Because immunoglobulin E-mediated reactions account for significant mortality and morbidity in association with penicillin use, the thrust of research on penicillin allergy has been to prevent such reactions. The many risk factors associated with subsequent immunoglobulin E-mediated penicillin allergy include history, timing and nature of previous penicillin exposure and/or allergy, age, route of administration, and response to skin testing with major and minor determinants of penicillin. The relative predictive values of each are discussed. Cross-reactivity between penicillin and its many analogs is reviewed and an approach to the patient who has a positive history for penicillin allergy and is in need of penicillin is offered.
尽管有许多新型抗生素可供使用，但青霉素及其众多半合成衍生物仍是许多感染的一线药物。这些药物即使在高剂量时也相对无毒；然而，它们的使用经常会引发过敏反应。对于有青霉素过敏高风险的患者，停止使用青霉素治疗是预防此类情况发生的最有效方法。由于免疫球蛋白E介导的反应在青霉素使用相关的死亡率和发病率中占很大比例，青霉素过敏研究的重点一直是预防此类反应。与随后免疫球蛋白E介导的青霉素过敏相关的许多风险因素包括既往青霉素暴露和/或过敏的病史、时间和性质、年龄、给药途径以及对青霉素主要和次要决定簇皮肤试验的反应。讨论了每种因素的相对预测价值。综述了青霉素与其许多类似物之间的交叉反应，并为有青霉素过敏史且需要使用青霉素的患者提供了一种处理方法。
