A case report on ceftrioxone induced hypersensitivity reactions (urticaria)
Corresponding Author(s) : R Siddarama
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 3 No. 2 (2015): 2015 Volume 3- Issue -2
Abstract
Ceftriaxone is a third generation cephalosporin group of broad spectrum anti-biotic. It active against the gram positive and gram negative organisms. Which is commonly used antibiotic in patients with various infections like respiratory tract infection, urinary tract infection, enteric fever and meningitis. Hypersensitivereactions subsequent ceftriaxone therapy is unusual but is potentially life-threatening. It is rapidly occurring reactions, hence called immediate hypersensitivity reactions. Whenever the patient exposure to certain drugs (penicillin, cephalosporin's and aspirin ) production of IgE antibodies – fix to mast cells then again re-exposure to the same drug antigen-antibody reaction occurs on the mast cell surface then release of inflammatory mediators like histamine, 5-HT, PGs, LTs, PAF these mediators cause the hypotension, bronchospasm, angioedema, urticarial, rhinitis and anaphylactic shock.The management of hypersensitivity reactions which include inj.Adrenalin 0.3to0.5ml, intramuscularly, inj.Hydrocortisone 100to200mg, intravenously, inj. Pheniramine 45 mg intravenously. Here we report a 28 years female who presented with the hypersensitivity reactions with ceftriaxone therapy.
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[1] Petri WA. Penicillins, cephalosporins, and other ?-lactamantibiotics. In: Brunton LL, LazoJS, Parker KL, editors.Goodman & Gilman’s the pharmacologic basis of therapeutics.11th ed. New York: McGraw-Hill;2006. p. 1127-54.
[2] Kelkar PS, Li JT.Cephalosporinallergy.NewEngJMed2001;345(11):804-9.
[3] Kumar P,GirdharKK,Anand R, Khera G. Life claiminganaphylaxis to intravenous ceftriaxone after negative skintest.The Indian Anaesthetists’ Forum[serial online].2005[cited 2012 Dec 17];6(2):1-6. Available from: URL: www.theiaforum.org.
[4] Bhagwat AG, Saxena KN. Intraoperative anaphylaxis toinjection ceftriaxone: Here we go again. Indian J Anesth2008;52(4):462-6.
[5] Drug allergy: An updated practice parameter. Ann AllergyAsthma Immunol2010;105(4):259 73.
[6] Novalbos A, Sastre J, Cuesta J,De Las Heras M, Lluch-Bernal M, Bombín C, et al. Lack of allergic cross reactivityto cephalosporin among patients allergic to penicillins.ClinExpAllerg2001;31(3):438-43.
[7] Saxon A, Beall GN, Rohr AS, Adelman DC. Immediatehypersensitivity reaction to beta lactam antibiotics.Ann InternMed 1987;107(2):204-15.
[8] Pichichero ME. Cephalosporins can be prescribed safely forpenicillin-allergic patients. JFamPract2006;55(2):106-12.
[9] Park M, Li TC. Diagnosis and management of penicillinallergy.Mayo ClinProc2005;80:405.
[10] Krivoy N, Taer M, Neuman MG. Antiepileptic drug-induced hypersensitivitysyndrome reactions. Curr Drug Saf 2006; 1(3):289-99.
[11] Classen DC, Pestonik SL, Evans RS, Lioyd JF,Burke JP (1997) Adverse drug events in hospitalizedpatients excess length of stay, extra cost andattributable mortality. J Am Med Assoc 277: 301–306.
[12] Naldi L, Conforti A, Venegoni M (1999)Cutaneous reactions to drug: an analysis ofspontaneous reports in four Italian regions. BritishJ ClinPharmacol 48: 839–846.
[13] Russelian A, Chandrasekaran V, Nanda C,Palanisamy S (2013) Hypersensitivity due to ceftriaxone mimicking measles in a child. Ind JPharmacol 45: 528-529.
[14] Rutnin NO, Kulthanan K, Tuchinda P,Jongjarearnprasert K (2011) Drug-induced urticaria: causes and clinical courses. J Drugs Dermatol 10:1019-1024.
[15] Pichichero ME (2005) A review of evidencesupporting the American Academy of Pediatrics recommendation for prescribing cephalosporinantibiotics for penicillin-allergic patients. Pediatrics 115: 1048-57.
[16] Romano A, Gaeta F, Valluzzi RL, Alonzi C, Viola M, Bousquet PJ. Diagnosing hypersensitivity reactions to cephalosporins in Children.Pediatrics 2008;122:521-7.
References
[2] Kelkar PS, Li JT.Cephalosporinallergy.NewEngJMed2001;345(11):804-9.
[3] Kumar P,GirdharKK,Anand R, Khera G. Life claiminganaphylaxis to intravenous ceftriaxone after negative skintest.The Indian Anaesthetists’ Forum[serial online].2005[cited 2012 Dec 17];6(2):1-6. Available from: URL: www.theiaforum.org.
[4] Bhagwat AG, Saxena KN. Intraoperative anaphylaxis toinjection ceftriaxone: Here we go again. Indian J Anesth2008;52(4):462-6.
[5] Drug allergy: An updated practice parameter. Ann AllergyAsthma Immunol2010;105(4):259 73.
[6] Novalbos A, Sastre J, Cuesta J,De Las Heras M, Lluch-Bernal M, Bombín C, et al. Lack of allergic cross reactivityto cephalosporin among patients allergic to penicillins.ClinExpAllerg2001;31(3):438-43.
[7] Saxon A, Beall GN, Rohr AS, Adelman DC. Immediatehypersensitivity reaction to beta lactam antibiotics.Ann InternMed 1987;107(2):204-15.
[8] Pichichero ME. Cephalosporins can be prescribed safely forpenicillin-allergic patients. JFamPract2006;55(2):106-12.
[9] Park M, Li TC. Diagnosis and management of penicillinallergy.Mayo ClinProc2005;80:405.
[10] Krivoy N, Taer M, Neuman MG. Antiepileptic drug-induced hypersensitivitysyndrome reactions. Curr Drug Saf 2006; 1(3):289-99.
[11] Classen DC, Pestonik SL, Evans RS, Lioyd JF,Burke JP (1997) Adverse drug events in hospitalizedpatients excess length of stay, extra cost andattributable mortality. J Am Med Assoc 277: 301–306.
[12] Naldi L, Conforti A, Venegoni M (1999)Cutaneous reactions to drug: an analysis ofspontaneous reports in four Italian regions. BritishJ ClinPharmacol 48: 839–846.
[13] Russelian A, Chandrasekaran V, Nanda C,Palanisamy S (2013) Hypersensitivity due to ceftriaxone mimicking measles in a child. Ind JPharmacol 45: 528-529.
[14] Rutnin NO, Kulthanan K, Tuchinda P,Jongjarearnprasert K (2011) Drug-induced urticaria: causes and clinical courses. J Drugs Dermatol 10:1019-1024.
[15] Pichichero ME (2005) A review of evidencesupporting the American Academy of Pediatrics recommendation for prescribing cephalosporinantibiotics for penicillin-allergic patients. Pediatrics 115: 1048-57.
[16] Romano A, Gaeta F, Valluzzi RL, Alonzi C, Viola M, Bousquet PJ. Diagnosing hypersensitivity reactions to cephalosporins in Children.Pediatrics 2008;122:521-7.