Detection of serum IgE antibody directed to aminothiazole using immobilized cephalosporins without protein conjugation

It is well known that allergic reactions may sometimes occur in patients under treatment with β-lactam antibiotics. For the detection of antidrug antibodies in vitro, conjugation with human serum albumin has been considered to be essential. In this study, we found that cefotiam, cefpirome, and ceftazidime could be immobilized without conjugation to carrier protein to construct a solid-phase enzyme-linked immunosorbent assay (ELISA) system. We describe a patient (26-year-old female nurse) with contact urticaria induced by antibiotics. Using the serum of this patient, we successfully detected IgE antibody directed to the aminothiazolyl group of cephalosporins, which has not previously been reported. Results suggest that the simple ELISA using unconjugated antibiotics could be applicable to patients with allergy to some cephalosporins and the aminothiazole side chain of the cephalosporins could cause an IgE-mediated allergic reaction.