ALLERGIC REACTIONS TO PARENTERAL BETA-LACTAM ANTIBIOTICS IN PATIENTS WITH CYSTIC-FIBROSIS

Certain antibiotics, particularly piperacillin,have been reported to b e associated with a high incidence of allergic reactions in patients w ith cystic fibrosis. We initiated a study to determine the relative fr equency of allergic reactions, ie, drug-induced fever and rash, to par enteral beta-lactam antibiotics in adult patients with cystic fibrosis . Charts of 111 patients were reviewed for each hospitalization to ass ess allergic reactions. Of 90 evaluable patients, 26 patients develope d one or more allergic reactions to beta-lactam antibiotics. The numbe r of allergic reactions per number of patients receiving specific anti biotics were carbenicillin (4/56), mezlocillin (7/42), piperacillin (1 1/31), ticarcillin (1/20), cefazolin (0/24), ceftazidime (1/35), imipe nem/cilastatin (4/16), and nafcillin (3/36). The mean time to onset of drug-induced fever or of rash was 9.1 days. As a group penicillins ha d a higher frequency of allergic reactions than cephalosporins. The fr equency of reactions was greatest with acylaminopenicillins (mezlocill in and piperacillin) and imipenem/cilastatin. The results of this stud y indicate that in addition to piperacillin, mezlocillin and imipenem/ cilastatin may be associated with a high incidence of allergic reactio ns in patients with CF.