Other Antimicrobial Drugs

Abstract

Allergic reactions to commonly used antibiotics such as the tetracyclines, macrolides, and rifamycins are rare. Neomycin consistently ranks in the top 10 % of the most common causes of allergic contact dermatitis while the incidence of bacitracin allergy is in the range 8–9.5 %. The most commonly occurring adverse effects caused by vancomycin are termed, collectively, red man syndrome. Immediate type I allergy is the most well-defined sulfonamide-induced hypersensitivity reaction with the best defined allergenic drug structures. Antigen-presenting cells may produce sulfonamide hapten–protein antigen complexes and ultimately induce the T cell response to the drug. Cross-reactions with a wide variety of frequently used non-antibacterial drugs containing a common sulfonamide group are thought not to occur. Almost all reports of trimethoprim-induced hypersensitivities are of the immediate kind and three different trimethoprim allergenic determinants structures have been identified. IgE antibodies apparently specific for quinolones and positive skin tests in apparently normal, healthy controls have been demonstrated. Immediate type I mechanisms are responsible for the most important chlorhexidine-induced allergic reactions. The whole molecule has been identified as the allergenic determinant. In almost all cases of povidone–iodine hypersensitivity, polyvinylpyrrolidone not iodine has been implicated as the offending component.