cefuroxime-axetil and Drug-Hypersensitivity

Topics: Angina Pectoris; Anti-Bacterial Agents; Cefuroxime; Coronary Angiography; Coronary Restenosis; Drug Hypersensitivity; Drug-Eluting Stents; Echocardiography; Follow-Up Studies; Humans; Male; Middle Aged; Prosthesis Failure; Recurrence; Reoperation; Syndrome

A sixty-one year old female with a past history of asthma was admitted to the emergency department because of vertigo, nausea, vomiting, chest pain and generalized erythema after taking an oral dose of cefuroxime axetil. Electrocardiography showed ST segment elevation in inferior leads. After coronary angiography, type 2 variant of Kounis Syndrome is diagnosed. We present first drug induced Kounis Syndrome in an asthmatic patient with severe anaphylactic shock. The present report also shows that atopic people expressing an amplified mast cell degranulation may have more serious hemodynamic decompensation during hypersensitivity reactions.

Topics: Acute Coronary Syndrome; Anaphylaxis; Anti-Bacterial Agents; Asthma; Cefuroxime; Coronary Angiography; Diagnosis, Differential; Drug Hypersensitivity; Electrocardiography; Female; Humans; Middle Aged

Topics: Aged, 80 and over; Angina, Unstable; Anti-Bacterial Agents; Cefuroxime; Coronary Vasospasm; Diagnosis, Differential; Drug Hypersensitivity; Frail Elderly; Humans; Injections, Intramuscular; Male; Syndrome; Urinary Tract Infections

The tolerability, safety, and efficacy of cefuroxime axetil suspension was studied in 36 children (aged 3 mo to 12 y) who had been hospitalized for respiratory tract or soft-tissue infections. After receiving parenteral antibiotics for a mean of 3.7 days, children were discharged home to receive cefuroxime axetil suspension at doses of 10, 15, or 20 mg/kg every 8 or 12 hours for a mean of 8.2 days. One child was lost to follow-up. Three of 35 evaluated patients were withdrawn from therapy because of adverse events, one of which was a drug-related hypersensitivity reaction. Of the 32 children who completed therapy, 9 developed mild reactions including oral thrush, diarrhea, or diaper dermatitis; none were withdrawn from therapy. Complete clinical cure occurred in 28 children (80 percent); 4 (11.4 percent) were clinically improved but still required an additional antibiotic within one week of completing therapy with cefuroxime axetil suspension. This favorable tolerability and safety of cefuroxime axetil suspension warrants further efficacy trials in pediatric patients.

Topics: Anti-Bacterial Agents; Cefuroxime; Cellulitis; Child; Child, Preschool; Drug Hypersensitivity; Drug Tolerance; Female; Humans; Infant; Injections, Intravenous; Male; Prodrugs; Random Allocation; Respiratory Tract Infections; Suspensions; Treatment Outcome