Localized pustulosis induced by betalactams.

J Investig Allergol Clin Immunol

Allergy Service, Jiménez Díaz Foundation, Universidad Autónoma de Madrid, Spain.

Published: December 2000

AI Article Synopsis

  • A case study describes a patient who developed pinpoint pustules in the mouth area after taking antibiotics ceftibuten and amoxicillin, suggesting a unique reaction.
  • The patient underwent various skin tests to identify specific allergies, but results were mostly negative for other tested antibiotics.
  • The tests indicated that the pustular eruption was likely due to a specific hypersensitivity to beta-lactam antibiotics rather than a general reaction to antibiotics in general.

Article Abstract

Localized forms of pustular drug eruptions related to antibiotics are uncommon and their mechanism is still unknown. We describe herein a patient who developed numerous pin-head pustules without erythema in the peribuccal area after ingestion of ceftibuten and amoxicillin. The relationship with these drugs was confirmed by single-blind oral challenges. The following tests were performed: prick and intradermal tests with benzylpenicilloyl polylysine, minor determinant mixture, benzylpenicillin and amoxicillin; patch tests were also carried out with benzylpenicillin, amoxicillin, cloxacillin, cefuroxime, ceftriaxone, cefazolin, ceftibuten and cefaclor. All cutaneous tests were negative. Controlled single-blind challenge tests were performed with amoxicillin, cefadroxil, ceftibuten, cefuroxime, cefaclor, erythromycin and ciprofloxacin. All betalactam antibiotics tested gave a positive reaction, with good tolerance of other antibiotics; this would appear to indicate a specific mechanism of hypersensitivity and not an unspecific reaction to wide spectrum antibiotics.

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