Beta-Lactam Antibiotic Sensitization and Its Relationship to Allergic Diseases in Tertiary Hospital Nurses.
10.4168/aair.2010.2.2.114
- Author:
Inseon S CHOI
1
;
Eui Ryoung HAN
;
Seong Wook LIM
;
Seong Ryoon LIM
;
Ji Na KIM
;
Sin Young PARK
;
Su Kyoung CHAE
;
Hye Hyeun LIM
;
Young Ae SEOL
;
You In BAE
;
Young Ho WON
Author Information
1. Allergy Division of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea. ischoi@chonnam.ac.kr
- Publication Type:Original Article
- Keywords:
Drug hypersensitivity;
beta-lactam antibiotics;
contact urticaria syndrome;
nurses
- MeSH:
Anti-Bacterial Agents;
Cefoperazone;
Cefotiam;
Ceftizoxime;
Cephalosporins;
Cough;
Drug Hypersensitivity;
Food Hypersensitivity;
Hand;
Hypersensitivity;
Penicillin G;
Physical Examination;
Piperacillin;
Rhinitis;
Rhinitis, Allergic, Perennial;
Risk Factors;
Skin;
Skin Tests;
Tertiary Care Centers;
Urticaria;
Surveys and Questionnaires
- From:Allergy, Asthma & Immunology Research
2010;2(2):114-122
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Skin allergies through type 1 and 4 hypersensitivity reactions are the most frequent manifestations of drug allergies. We had previously experienced a case of a nurse with cefotiam-induced contact urticaria syndrome. To aid in preventing the progression of drug-induced allergic disease in nurses, we conducted a survey of tertiary hospital nurses who were likely to have been exposed professionally to antibiotics. METHODS: All 539 staff nurses at a tertiary hospital were asked to respond to a questionnaire regarding antibiotic exposure. Of the 457 nurses (84.8%) who responded, 427 (79.2%) received a physical examination of the hands and 318 (59.0%) received skin prick tests with the beta-lactam antibiotics cefotiam, cefoperazone, ceftizoxime, flomoxef, piperacillin and penicillin G. RESULTS: A positive response to at least one of the antibiotics occurred in 8 (2.6%) of the 311 subjects included in the analysis and stages 1 and 2 contact urticaria syndrome were observed in 38 (8.9%) and 3 (0.7%) of 427 nurses, respectively. The frequencies of a positive antibiotic skin test (6.9 versus 1.3%, chi-square=7.15, P=0.018), stage 1 contact urticaria syndrome (14.4 versus 7.4%, chi-square=4.33, P=0.038) and drug allergy (15.3 versus 3.6%, chi-square=18.28, P=0.000) were higher in subjects with a positive skin allergy history than in those without. Allergic rhinitis (P=0.02, OR=3.86, CI=1.23-12.06), night cough (P=0.04, OR=3.12, CI=1.03-9.41) and food allergy (P=0.00, OR=9.90, CI=3.38-29.98) were significant risk factors for drug allergy. CONCLUSIONS: Antibiotic sensitization and drug allergy occurred more frequently in nurses with a positive skin allergy history. Atopy may be an important risk factor for drug allergy.