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Title Clinical Features and Signficance of in Vitro Testing of 16 Cases of Amoxicillin-Induced Hypersensitivity Reactions
Author Han-Jung Park, Gyu-Young Hur, Hyoun-Ah Kim, Gil-Soon Choi, Sung-Jin Choi and Hae-Sim Park
Place of duty Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Amoxicillin is one of the broad spectrum antibiotics and is widely used in the treatment of various infective diseases. There are various forms of amoxicillin- induced hypersensitivity reactions including urticaria/angioedema, erythema multiforme and anaphylaxis.

Objective: To observe the clinical features and evaluate the significance of in vitro testing of amoxicilin-induced hypersensitivity reactions.

Method: We retrospectively reviewed medical records of patients diagnosed as having amoxicillin-induced hypersensitivity reactions from January 2002 to February 2007. Serum-specifc IgE antiboides to ampicilloyl (AMP) and amoxicilloyl (AXO) were determined using the immunoCAP system.

Result: Sixteen subjects were enrolled in this study. Clinical features of amoxicillin-induced hypersensitivity reactions included erythema multiforme (n=6, 37.5%), urticaria/angioedema (n=4, 25.0%), anaphylaxis (n=3, 18.8%), maculopapular skin eruption (n=2, 12.5%) and fixed-drug eruptions (n=1, 6.3%). Six subjects had a high serum specific IgE to AMP and all anaphylaxis patients had a high serum specific IgE to AXO and/or AMP.

Conclusion: These findings suggest that amoxicillin could induce various cutaneous manifestations in which the most common ones are erythema multiforme and urticaria/ angioedema. The serious reactions of anaphylaxis were noted in 18.8% of subjects in which IgE mediated responses to 2 antigenic determinants were involved. (Korean J Asthma Allergy Clin Immunol 2007;27:162-167)

Key_word Drug allergy, Hypersensitivity response, Amoxicillin
Publication info Korean J Asthma Allergy Clin Immunol 2007 Sep; 027(03): 162-167.
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