2026-06-01T09:06:59Zhttps://riuma.uma.es/rest/oai/requestoai:riuma.uma.es:10630/331312026-02-03T10:51:32Zcom_10630_2254col_10630_37953
RIUMA. Repositorio Institucional de la Universidad de Málaga
author
Torres-Jaén, María Josefa
author
Montañez-Vega, María Isabel
author
Ruiz-Sanchez, Antonio Jesus
2024-09-25T07:04:50Z
2024-09-25T07:04:50Z
2010
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
https://hdl.handle.net/10630/33131
10.1111/j.1398-9995.2009.02245.x
Background: Skin testing of subjects with immediate hypersensitivity to amoxicillin
is 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 of
amoxicillin in subjects with immediate allergic reactions to amoxicillin to improve
skin test sensitivity.
Methods: Amoxicillin, amoxicilloic acid, and diketopiperazine were prepared and
characterized by reverse-phase HPLC, tested in vivo by skin testing and in vitro by
basophil activation test and RAST inhibition assay.
Results: Patients with immediate hypersensitivity to amoxicillin were selected: Group
A (n = 32), skin test positive just to amoxicillin; Group B (n = 19), skin test positive
to benzylpenicillin determinants; Group C (n = 10), skin test negative and
amoxicillin drug provocation test positive. In Group A, 27 subjects (81.8%) were
skin test positive to amoxicillin, ten (30.3%) to amoxicilloic acid, two (6.1%) to
diketopiperacine, and six (18.2%) negative. In Group B, nine (50%) were positive
to amoxicillin, eight (42.1%) to amoxicilloic acid, none to diketopiperacine, and
nine (50%) negative. In Group C, skin tests were negative. BAT was positive to
amoxicillin in 26 patients (50.9%), to amoxicilloic acid in 15 (29.1%), and diketopiperazine
in four (7.8%). RAST inhibition studies showed > 50% inhibition in all
sera, with the highest concentration of amoxicillin and amoxicilloic acid.
Conclusions: The combination of minor determinants of amoxicillin, amoxicilloic
acid, and diketopiperazine seems to be of no greater value than the use of amoxicillin
alone. Further efforts are needed to find new structures to improve sensitivity in
the diagnosis of immediate hypersensitivity to betalactams.
eng
Alergia a los medicamentos
Penicilina - Efectos secundarios
Role of minor determinants of amoxicillin in the diagnosis of immediate allergic reactions to amoxicillin.
journal article
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
URL
https://riuma.uma.es/bitstreams/83b8f173-8da6-4986-a2b3-e4b11d93f05a/download
File
MD5
457f11ded638d58f4a718cce8048db9a
333994
application/pdf
2010 - Torres et al. - Allergy v.pdf