European Journal of Biomedical and Pharmaceutical Sciences

A REVIEW OF ANTIBIOTIC-INDUCED DRUG ALLERGIES: MECHANISMS, PREVALENCE, AND FUTURE PERSPECTIVES

Ghassan Shannan, Zeina S. Malek and Nasser Thallaj*

ABSTRACT

Drug allergies pose a significant public health challenge, contributing to a substantial proportion of adverse drug reactions, particularly among antibiotics. This review explores the mechanisms underlying drug allergies, emphasizing the role of antibiotics, which frequently induce hypersensitivity reactions. Drug allergies are classified into immediate and delayed hypersensitivity types, with immediate reactions mediated by immunoglobulin E (IgE) and delayed responses involving T lymphocytes. A critical aspect of antibiotic-induced allergies is haptenization, where antibiotics interact with host proteins, forming antigenic determinants that trigger immune responses. Recent studies highlight the prevalence of allergic reactions to specific antibiotics, such as amoxicillin and sulfamethoxazole, raising concerns regarding their clinical use and management. The review examines the emerging pharmacologic interaction (p-i) concept, which suggests that certain antibiotics may activate T lymphocytes directly without requiring haptenization. Additionally, the diagnostic challenges associated with distinguishing true allergic reactions from adverse drug effects are discussed, emphasizing the need for more sensitive and specific testing methods. This review aims to synthesize current knowledge on antibiotic-induced allergies, identify gaps in understanding, and propose future research directions. By enhancing our understanding of the immunological mechanisms involved, this work seeks to improve diagnostic and therapeutic strategies, ultimately contributing to better patient safety and care in clinical settings.

Keywords: Drug allergies; Antibiotics; Hypersensitivity; Haptenization; Immunoglobulin E (IgE); Pharmacologic interaction (p-i); Diagnosis; Amoxicillin.