Hypersensitivity to antibiotics

This chapter deals with adverse drug reactions (ADRs), which are separated into type A and type B reactions. Type A reactions are predictable from known pharmacologic properties and are largely dose related; these make up 85% to 90% of all ADRs. Type B reactions are unpredictable and are restricted to a vulnerable subpopulation; these include immunologic drug reactions, drug intolerance, and idiosyncratic reactions. The chapter looks at immune mechanisms that are thought to be involved in 6% to 10% of all ADRs. It analyzes allergenic drugs that can induce the entire spectrum of immunopathologic reactions, which are clinically indistinguishable from reactions elicited by foreign macromolecules. Testing and evaluation of patients with ADRs and methods for overcoming these limitations are discussed.