Antibiotic anaphylaxis

Anaphylactic reactions following the injection of penicillin or other antibiotics have increased greatly during the past several years. These untoward reactions to penicillin were infrequent during the first nine years of penicillin therapy and there can be no doubt that hypersensitivity to these drugs is developing in many people. Therefore promiscuous use of them is to be condemned. It is safer not to use antibiotics parenterally in patients with allergic conditions such as bronchial asthma. The further use of a particular antibiotic should be avoided if the patient has previously shown any hypersensitivity to that drug.A questionnaire was answered by more than 1,000 California physicians who reported that over 300 patients had severe anaphylactic reactions from parenteral penicillin and streptomycin. There were seven deaths. Since the antibiotics should still be used when needed, prevention of anaphylaxis is of fundamental importance. The frequency of these reactions can be greatly reduced by the use of antihistaminic solutions combined with the antibiotics. Treatment of these shock-like reactions demands the prompt administration of epinephrine intramuscularly, antihistaminic solutions intravenously and oxygen.