tetracycline and Serum-Sickness

Because minocycline can cause serious adverse events including hypersensitivity syndrome reaction (HSR), serum sicknesslike reaction (SSLR), and drug-induced lupus, a follow-up study based on a retrospective review of our Drug Safety Clinic and the Health Protection Branch databases and a literature review was conducted to determine if similar rare events are associated with tetracycline and doxycycline. Cases of isolated single organ dysfunction (SOD) attributable to the use of these antibiotics also were identified.. Nineteen cases of HSR due to minocycline, 2 due to tetracycline, and 1 due to doxycycline were identified. Eleven cases of SSLR due to minocycline, 3 due to tetracycline, and 2 due to doxycycline were identified. All 33 cases of drug-induced lupus were attributable to minocycline. Forty cases of SOD from minocycline, 37 cases from tetracycline, and 6 from doxycycline were detected. Hypersensitivity syndrome reaction, SSLR, and SOD occur on average within 4 weeks of therapy, whereas minocycline-induced lupus occurs on average 2 years after the initiation of therapy.. Early serious events occurring during the course of tetracycline antibiotic treatment include HSR, SSLR, and SOD. Drug-induced lupus, which occurs late in the course of therapy, is reported only with minocycline. We theorize that minocycline metabolism may account for the increased frequency of serious adverse events with this drug.

Topics: Adolescent; Adult; Adverse Drug Reaction Reporting Systems; Anti-Bacterial Agents; Arthralgia; Canada; Databases as Topic; Doxycycline; Drug Eruptions; Drug Hypersensitivity; Drug Prescriptions; Female; Fever; Follow-Up Studies; Humans; Liver; Lupus Erythematosus, Systemic; Male; Middle Aged; Minocycline; Retrospective Studies; Safety; Serum Sickness; Syndrome; Tetracycline; Time Factors

Topics: Anaphylaxis; Angioedema; Anti-Bacterial Agents; Anti-Infective Agents; Carrier Proteins; Dose-Response Relationship, Drug; Drug Hypersensitivity; Exanthema; Humans; Hydrocortisone; Mast Cells; Peptides; Proteins; Serum Sickness; Skin Tests; Tetracycline; Urticaria

Topics: Anaphylaxis; Anti-Bacterial Agents; Dose-Response Relationship, Drug; Drug Hypersensitivity; Female; Fetal Diseases; Gastrointestinal Diseases; Hearing Disorders; Hematologic Diseases; Humans; Injections, Intramuscular; Injections, Intravenous; Kidney Diseases; Neomycin; Nervous System Diseases; Neuromuscular Diseases; Novobiocin; Penicillins; Pregnancy; Psychoses, Substance-Induced; Serum Sickness; Streptomycin; Tetracycline; Vision Disorders

Topics: Adult; Biological Assay; Chromatography, Thin Layer; Drug Hypersensitivity; Fluorescent Antibody Technique; Hemagglutination Tests; Humans; Male; Passive Cutaneous Anaphylaxis; Penicillins; Serum Sickness; Skin Tests; Tetracycline

Topics: Anaphylaxis; Anemia; Anemia, Hemolytic; Anti-Bacterial Agents; Drug Eruptions; Drug Hypersensitivity; Humans; Penicillins; Serum Sickness; Skin Manifestations; Tetracycline; Toxicology; Urticaria

Topics: Adult; Anaphylaxis; Antigen-Antibody Reactions; Drug Hypersensitivity; Humans; Lymphocytes; Male; Penicillins; Serum Sickness; Skin Tests; Tetracycline

Topics: Anaphylaxis; Anti-Bacterial Agents; Child; Debridement; Humans; Ireland; Penicillins; Protein Synthesis Inhibitors; Serum Sickness; Tetanus; Tetanus Antitoxin; Tetanus Toxoid; Tetracycline; Toxicology

Topics: Anaphylaxis; Anti-Bacterial Agents; Aspirin; Chemical and Drug Induced Liver Injury; Chloramphenicol; Colistin; Drug Eruptions; Drug Hypersensitivity; Hepatitis; Nitrofurantoin; Novobiocin; Penicillins; Polymyxins; Protein Synthesis Inhibitors; Serum Sickness; Streptomycin; Tetracycline; Toxicology

Topics: Anaphylaxis; Anti-Bacterial Agents; Eye Injuries; Humans; Hypersensitivity; Immunization Schedule; Ophthalmology; Penicillins; Serum Sickness; Tetanus; Tetanus Antitoxin; Tetanus Toxoid; Tetracycline

Cleansing and debridement is paramount in dealing with tetanus-prone wounds (severe crushing injuries, piercing wounds, blisters and burns are outstanding examples, particularly if contaminated with dirt, grass or other debris). Prophylaxis then is relatively easy in persons who have been actively immunized by toxoid injections. For them, a "booster" injection is indicated. Use of antitoxin, however, is hazardous, whether for prophylaxis or for treatment of the disease. Since it may in itself cause severe disease, including anaphylactic reaction and serum sickness, decision to use it must be weighed against the possibility of the development of tetanus in each case. To prepare for use of it, careful history should be taken, with particular reference to sensitivity to horse dander. Dermal tests, and perhaps ophthalmic tests, for sensitivity to the serum should be carried out. Even the tests may be hazardous and precautions should be taken accordingly. If it is decided that the use of antitoxin is necessary even though the patient is sensitive to the material, desensitization must be carried out promptly, with adequate preparation for severe reaction. There is experimental evidence that antibiotics of the tetracycline group, given soon after injury, may have prophylactic effect against tetanus.

Topics: Anaphylaxis; Anti-Bacterial Agents; Antitoxins; Burns; Debridement; Humans; Immunization; Serum Sickness; Tetanus; Tetanus Toxoid; Tetracycline; Vaccination