RT Journal Article
T1 Role of minor determinants of amoxicillin in the diagnosis of immediate allergic reactions to amoxicillin.
A1 Torres-Jaén, María Josefa
A1 Montañez-Vega, María Isabel
A1 Ruiz-Sanchez, Antonio Jesus
K1 Alergia a los medicamentos
K1 Penicilina - Efectos secundarios
AB Background: Skin testing of subjects with immediate hypersensitivity to amoxicillinis performed using major and minor determinants of benzylpenicillin plus amoxicillin.However, sensitivity is not optimal, and other determinants need to be considered.We assessed the sensitivity of stable, well-characterized minor determinants ofamoxicillin in subjects with immediate allergic reactions to amoxicillin to improveskin test sensitivity.Methods: Amoxicillin, amoxicilloic acid, and diketopiperazine were prepared andcharacterized by reverse-phase HPLC, tested in vivo by skin testing and in vitro bybasophil activation test and RAST inhibition assay.Results: Patients with immediate hypersensitivity to amoxicillin were selected: GroupA (n = 32), skin test positive just to amoxicillin; Group B (n = 19), skin test positiveto benzylpenicillin determinants; Group C (n = 10), skin test negative andamoxicillin drug provocation test positive. In Group A, 27 subjects (81.8%) wereskin test positive to amoxicillin, ten (30.3%) to amoxicilloic acid, two (6.1%) todiketopiperacine, and six (18.2%) negative. In Group B, nine (50%) were positiveto amoxicillin, eight (42.1%) to amoxicilloic acid, none to diketopiperacine, andnine (50%) negative. In Group C, skin tests were negative. BAT was positive toamoxicillin in 26 patients (50.9%), to amoxicilloic acid in 15 (29.1%), and diketopiperazinein four (7.8%). RAST inhibition studies showed > 50% inhibition in allsera, with the highest concentration of amoxicillin and amoxicilloic acid.Conclusions: The combination of minor determinants of amoxicillin, amoxicilloicacid, and diketopiperazine seems to be of no greater value than the use of amoxicillinalone. Further efforts are needed to find new structures to improve sensitivity inthe diagnosis of immediate hypersensitivity to betalactams.
PB Wiley
YR 2010
FD 2010
LK https://hdl.handle.net/10630/33131
UL https://hdl.handle.net/10630/33131
LA eng
NO Torres, M.J., Ariza, A., Fernández, J., Moreno, E., Laguna, J.J., Montañez, M.I., Ruiz-Sanchez, A.J. and Blanca, M. (2010), Role of minor determinants of amoxicillin in the diagnosis of immediate allergic reactions to amoxicillin. Allergy, 65: 590-596. https://doi.org/10.1111/j.1398-9995.2009.02245.x
NO Política de acceso abierto tomada de: https://v2.sherpa.ac.uk/id/publication/3704
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 1 jun 2026