[Allergy to drugs and contrast media--recommendations of the Israeli Allergy and Clinical Immunology Association]

Abstract

Drug hypersensitivity is an adverse reaction that was brought about by a specific immunologic response, not related to the pharmacological components of the drug. Additionally, drug related pseudoallergic and anaphylactoid reactions have been encompassed under the umbrella of hypersensitivity. Some of these reactions are linked with significant morbidity and mortality. Nowadays, the hypersensitivity reactions of most drugs can be well defined and recurrence risk following exposure to the culprit drug and/or related drugs can be assessed. Medical history skin, blood and challenge tests, conducted in an allergy clinic, enable prediction and prevention of repeated events as well as unnecessary avoidance of certain compounds. For instance, most patients who report a prior reaction to penicillin are not allergic to beta-lactams upon allergic evaluation, while avoidance of penicillin based on self-reporting alone often leads to the use of an alternate antibiotic with greater cost or side effect profile. On the other hand, for patients who previously exhibited hypersensitivity to a compound which is currently required, premedication or a desensitization protocol can be recommended to allow the use of this compound. Drug hypersensitivity is most commonly attributed to beta-lactams antibiotics, contrast media reagents and non-steroidal anti-inflammatory drugs (NSAID). Hence, in the current review the recommendations of the Israeli Association for Allergy and Clinical Immunology for the evaluation and treatment of patients suspected to have hypersensitivity to beta-lactams and contrast media reagents are detailed. Recommendations regarding the evaluation of NSAID hypersensitivity will be published on the IMA website, together with those explicated herein.