Allergic hypersensitivity to neomycin. Relationship between patch test reactions and 'use' tests

Abstract

The prevalence of neomycin patch test sensitivity in the general population is approximately 1%. We describe the relationship between positive neomycin patch tests and clinical "use tests" with two antibiotic combinations (Neosporin G cream and Neosporin ointment). The neomycin use test was positive in seven of eight subjects with a strongly positive patch test, and in two of four subjects with a weakly positive patch test. A positive use test usually occurred earlier and was always more intense with the cream base. The use test reactions were usually mild even with continued application of the antigen. Use tests with commercial products may be helpful in evaluating the clinical relevance of positive patch tests.

Periorbital Allergic Contact Dermatitis - The Most Common Allergens in the Czech Republic

“…Allergic contact dermatitis from neomycin was first described in 1952 [14]. Prystowsky, et al determined the frequency of neomycin allergy in the general population to be 1.1% [15]. In 10 European centers, the sensitization rates varied from 1.1 do 3.8% [16].…”

Allergic contact dermatitis from tacrolimus

“…For example, neomycin sulfate is typically used clinically at a concentration of 0.5% (0.35% neomycin) in antibiotic ointments, yet the standard patch test concentration is 20% in petro1atum. [6][7][8] This high concentration is used due to the repeated observation that patch testing with a patient's own neomycin-containing cream or ointment, or with neomycin in petrolatum at in-use concentration, yields a high rate of false-negative results. 9,10 Even neomycin sulfate 20% in petrolatum may result in false-negative patch test reactions.…”

Topische Antibiotika und Antiseptika

“…Gette et al [26] fanden bei 5,3 % aller Patienten, die postoperativ eine topische Wundinfektionsprophylaxe mit Neomycin erhielten, eine im Epikutantest bestätigte Neomycin-Sensibilisierung. In der Allgemeinbevölkerung fand sich eine Prävalenz von 1 % mit nachgewiesener Neomycin-Sensibilisierung [65,68]. Bei 40-55 % der Neomycin-sensibilisierten Personen finden sich ᭤ Kreuzreaktionen mit Gentamicin ohne vorherige Exposition [71].…”