Hypersensitivity Reactions to Non-Beta Lactam Antibiotics

Abstract

Purpose of Review Hypersensitivity reactions (HRs) to non-beta lactam antibiotics (NBLAs) have increased over the last years. Although NBLAs with their broad spectrum are widely used to treat various infections, knowledge about HRs due to these drugs is limited when compared to beta-lactam antibiotics (BLAs). Therefore, we aimed to discuss the structures, subgroups of various NBLAs including fluoroquinolones, macrolides, sulfonamides, first-line anti-tuberculosis agents, 5-nitroimidazols, aminoglycosides, glycopeptides, clindamycin, and tetracyclines, and we also reviewed epidemiology, clinical characteristics, cross-reactivity, diagnostic methods, and management of related HRs. Recent Findings These agents can lead to occurrence of immediate and/or non-immediate HRs mediated by immunologic and/or non-immunologic mechanisms. There are no validated in vivo or in vitro tests for their diagnosis. Management strategy is similar to that of HRs due to BLAs which includes avoidance or desensitization. In this article in vivo and in vitro diagnostic tests and management strategies for NBL HRs are discussed in detail to provide guidance for daily clinical practice.