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Allergy to penicillin
Last reviewed: 23.04.2024
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Allergy to penicillin is an extremely topical problem, both in childhood and in adulthood. It is associated with the response of the human immune system to the production of specific IgE (immunoglobulin E) and the appearance of immune complexes in combination with other groups of antibodies. It should be noted that penicillin is a low-molecular substance, the appearance of antigenic properties of which is due to a covalent bond with the endogenous carrier protein.
Often the allergy to penicillin occurs in the age group from 20 to 49. In the course of a person's life, the sensitivity to penicillin may decrease or completely disappear. The prevalence of allergy to penicillin ranges from 0.75 to 0.8%, anaphylactic shock is noted in no more than 0.01% of cases.
[How does the penicillin allergy manifest?
An allergic reaction will not keep you waiting. The allergy to penicillin manifests itself in different ways and is subdivided by the rate of onset of symptoms, provided the drug is secondarily administered. She may be:
- early - manifested after 30 min. In the form of urticaria, anaphylactic shock;
- delayed - occurs after 2-72 hours, manifests itself by itchy skin, reddening of the skin, spasm in the bronchi, flow of the larynx;
- late - after 72 hours, accompanied by the appearance of skin dermatitis, patchy-papular rash, febrile condition, arthralgia.
To rare, severe manifestations of allergies to penicillin include the syndromes of Stevens-Johnson and Lyell, interstitial nephritis, systemic vasculitis, hemolytic anemia, neuritis and the like.
If it is possible to replace penicillin with another antibiotic, no skin tests are performed to identify the allergen. This is due to the fact that the development of an allergy to medicines is unpredictable, and the diagnosis of a skin test is valuable in a strictly limited time interval. These samples also do not predict the occurrence of adverse events in the patient.
Along with skin tests that detect allergy to penicillin, a radioallergosorbent test is performed, which is less sensitive, requires a lot of time, is specific and does not reveal IgE to small amounts of antigenic determinants of penicillin.
Allergy to penicillin in children
A serious problem is the child's allergy to penicillin. It is in childhood that infectious diseases occur that are treated with antibiotics of the penicillin group. In children, rashes appear, which is often associated with an allergic reaction to this antibiotic. Here the main thing is not to get into a panic and understand that the very infectious disease can cause rashes on the skin. Only 1% of children actually detect an allergy to penicillin. Children with allergies do not have a predisposition to allergy to the antibiotics of the penicillin group. Therefore, the presence of asthma in the child does not at all mean that penicillin is contraindicated. Anaphylactic shock occurs in 0.2% with penicillin injection.
The child has an allergy to penicillin manifested in:
- skin - itchy or maculopapular rash, less often Stevens-Johnson syndrome and necrolysis with toxic epidermal;
- respiratory tracts - in the form of a laryngeal edema, an asthmatic condition.
Precursors of anaphylactic shock are: itching, low blood pressure, redness and bronchial spasm. After applying penicillin, there are also: fever, anemia, erythroderma, nephritis.
Allergy to penicillin: treatment
If you discover the first signs of an allergy to penicillin, it is recommended immediately to use emergency medical help. In the most difficult situations apply the introduction of "epinephrine". And the dosage is selected depending on the situation. With bronchial spasm in children and anaphylaxis, a maximum of 0.3 mg is prescribed with the possible administration of this dose up to 3-4 times in 15 minutes. Dosage for newborns is 10-30 μg / kg in the interval of 3-5 minutes. Children over the month are given 10 μg / kg of medication, followed by a dose increase of up to 100 μg / kg every 3-5 minutes. Adults with an anaphylactic shock are administered 0.1-0.25 mg of a drug diluted in 10 ml of a 0.9% NaCl solution. If necessary, repeat the administration up to three times in 10-20 minutes.
The allergy to penicillin is treated by the course of intravenous injections of corticosteroids and antihistamines, which show good results in the initial stages of the disease. In the case of anaphylaxis previously fixed on penicillin, it will be necessary to use "epinephrine".
The consequence of an allergic reaction to this antibiotic can be fatal. When red spots appear, problems with breathing and a positive result of skin test for penicillin, it is necessary to immediately replace the drug.
Amoxiclav in case of allergy to penicillin
Amoxiclav is released in tablets and a dry powder to form a slurry. "Amoxiclav" has a wide range of applications. He is appointed to combat infections caused by sensitive strains of microorganisms. Successfully used for gynecological problems, treatment of the gastrointestinal tract, ENT organs, infectious diseases of the skin, urinary tract, etc.
Amoxiclav is an antibiotic of the penicillin group, consisting of the active substance amoxicillin and clavulanic acid. The principle of its effect is based on the destruction of cells of pathogenic bacteria. Destructive for most microorganisms, among them: streptococci, shigella, eisheerichia, proteus, enterococcus and others.
Amoxiclav in case of allergy to penicillin can be used as a medicine strictly according to the doctor's prescription. Among the contraindications, sensitivity to cephalosporins and beta-lactam antibiotics, mononucleosis of infectious type (including korepodobnuyu rash). Only under the supervision of a doctor, medicine is prescribed for pregnant women, during lactation, for gastrointestinal problems and liver diseases.
An allergy to penicillin may not manifest itself when taking amoxiclav, because on one penicillin the body responds with an allergy, and to others of the same group it can be just sensitive. Do not forget that amoxiclav has an impressive list of side effects. These can be various skin reactions, anaphylactic shock, angioedema and Stevens-Johnson syndrome. Therefore, the drug is used after consultation with your doctor.
How to prevent allergy to penicillin?
Prevention is the introduction of a small amount of penicillin followed by a smooth increase in the dose to obtain a stable result without signs of allergy to penicillin. This method helps the body to adapt to the antibiotic and to perceive it without allergic manifestations, which eventually disappear completely. This procedure has one minus - it does not give a lasting result, so before the next course of taking penicillin it will need to be repeated.
Sometimes, after the introduction of penicillin, skin rashes resembling measles are observed. It is important to understand that this is not an allergy to penicillin. Every medical product has side effects and penicillin is not an exception. Therefore, it is not necessary to start convulsively to drink antihistamines. The presumed penicillin allergy may be caused by the action of other antibiotics concurrently taken with penicillin.