[Clinical and immunological analysis of 1,047 allergic reactions to penicillin].

  • 26 July 1975
    • journal article
    • research article
    • Vol. 105  (30) , 953-6
Abstract
Of 1047 patients who had had an allergic reaction to penicillin established by clinical and laboratory findings, 224 were given penicillin therapy again later. One third of these patients developed a second allergic reaction to penicillin. In patients experiencing a second allergic reaction the most striking feature is a dramatic increase in the immediate reactions and especially of the anaphylactic type, and less markedly, an increase in the serum-sickness type of reaction. All the patients were skin tested with penicilloyl-polylysine (PPL) and benzylpenicillin (BPO). Circulating hemagglutinating antibodies were determined and in vitro stimulation of peripheral blood lymphocytes was performed in all cases. Skin tests show little change for several years. In contrast, circulating hemagglutinating antibodies disappear in half the cases within 6 months. Finally, lymphocyte stimulation with penicillin was positive in only 50% three months after onset of the allergic reaction, whereas one year later there was a 73% positive response. The best test for prediction of an allergic reaction to penicillin appears to be determination of the (high) and (low) reactors among patients with a positive skin test to PPL and BPO.

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