POSSIBLE METHODS OF IN VITRO DIAGNOSTICS TO IDENTIFY INTOLERANCE TO BETA-LACTAM ANTIBIOTICS IN PATIENTS WITH BRONCHIAL ASTHMA

Abstract

With basophilic test the evaluation of spectrum and prevalence of intolerance to beta-lactam antibiotics in 48 patients with allergic asthma, non-allergic and mixed form of the disease and the assessment of its descriptiveness were done in relation to the data history and the results of the study of total and specific IgE antibodies to penicillins and cephalosporins in these patients serum by immunoassay. The analysis of the results helped to reveal a statistically significant difference in the detection of sensitization with two diagnostic methods. Thus during basophilic test with beta-lactam antibiotics 39.5% of patients were confirmed to have this group drugs intolerance, while the second method revealed this in 14.6% of the patients (p<0.01). It is shown that sensitization to these antibiotics in patients with bronchial asthma by basophilic test was significantly higher (p<0.05) than in the control group (healthy people), and significant for cephalosporins of the 2^nd generation and carbapenems. The highest percentage of marked intolerance was to cephalosporins of the 2^nd generation and carbapenems (57.9%), as well as the cephalosporins of the 1^st generation (56%). High level of total IgE (more than 100 IU/ml) was revealed in 27 (56.3%) patients and was in the range of 105.0 to 534.8 IU/ml. The increase of specific IgE to drugs allergens was in the group of patients with allergic bronchial asthma (28.6%). In the groups with mixed and non-allergic forms of the disease the formation of intolerance may have occurred mainly by non-IgE-mediated mechanisms. The level of total IgE of patients did not correlate with the level of specific IgE for drug allergens and basophilic test activity.