Penicillin hypersensitivity. Determination and classification of anti-penicillin antibodies by the enzyme-linked immunosorbent assay

Abstract

An enzyme-linked immunosorbent assay for the detection of anti-pencillin antibodies of the several Ig classes is described. The results of the ELISA in 350 sera of patients suspected of penicillin hypersensitivity are compared with those of the haemagglutination test. In 105 sera penicillin-specific IgM and/or IgG was demonstrated with the ELISA, the HA test being positive in 49 of these 105 sera. However , in another 14 sera IgM anti-penicillin antibodies could be shown only with the HA. In 10 sera penicillin-specific IgE was demonstrated with the ELISA, only four of these being also positive with the RAST. IgE was always found in combination with IgG and/or IgM. The positive correlation of the ELISA and the RAST with the intracutaneous test on penicillolypolylysine was 26.9% and 15.4% respectively. The ELISA is a simple and reproducible method for the detection of anti-penicillin antibodies, being more sensitive than the HA and the RAST.