Tolerance Test in Patients With Multiple Drug Allergy Syndrome

Abstract

Multiple Drug Allergy Syndrome (MDAS) is a frequent clinical condition characterized by reactions to more than one different class of antibiotics. Even if some studies have previously reported an increased rate of allergic reactions to drugs in patients with a history of antimicrobials and NSAIDs allergy, risk factors and pathogenesis of MDAS are still object of investigation. Moreover, in these subjects it is often difficult to prescribe a safe alternative antibiotic without a tolerance test. In this study we carried out 504 tests in 460 patients with a history of immediate adverse reactions to antibiotics. From the analysis of our results it emerges that risk factors for MDAS are female sex and intolerance to NSAIDs. Risk factors for positive tolerance test are male sex, intolerance to NSAIDs and a history of MDAS, respectively. In conclusion, it seems that tolerance test may represent a valid approach to detect a safe antibiotic in these patients.

Multiple drug intolerance syndrome and multiple drug allergy syndrome: Epidemiology and associations with anxiety and depression

“…Risk factors for MDIS include female sex, older age, greater weight, prior hospitalizations, and multiple medical comorbidities . Female sex has also been identified as a risk factor for MDAS . Prior studies have suggested associations between MDIS and/or MDAS and various psychiatric comorbidities, including anxiety, depression, alexithymia, and somatization .…”

Distinct delayed T‐cell response to β‐methasone and penicillin‐G in the same patient

“…Contrasting data are available about the possibility that several individuals more likely than others might develop immediate adverse drug reactions (35–39). The case we presented of a patient reactive both to β ‐MT and pen‐G further support the existence of a multiple drug allergy syndrome also for delayed hypersensitivity (40).…”

Management of Multiple Drug Allergies in Children

“…It has been suggested that multiple drug allergy syndrome is a distinct clinical entity in the adult population and that it can be detected by tolerance tests [5][6][7]. Multiple antibiotic sensitivity has been reported among the pediatric population, with the incidence ranging from 11% to 40% of selected groups of children presenting with drug allergy reported by Park et al [8] and Kamada et al [9], respectively.…”