Table 1.
Patient characteristics and outcomes of desensitization
| Patient | Age,Sex | Initial Reaction | FEV1 (L) | (% predicted) | Lung Transplant | Antibiotic | Skin Test | Desensitization |
||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Protocol | # of courses (52) | Step/Reaction | Treatment | Completed | ||||||||
| 1 | 46,F | Urticaria,angioedema | 0.50–0.60 1 | (22–26) 1 | Yes | Meropenem | nd | 12 Step, 250 mL bag | 3 | No | — | Yes |
| 2 | 51,M | Urticaria | 2.19 | (66) | Yes | TMP/SMX | nd | 12 Step, 250 mL bag | 1 | No | — | Yes |
| 3 | 29,F | Urticaria | 1.40 | (43) | Yes | TMP/SMX | nd | 12 Step, 250 mL bag | 2 | No | — | Yes |
| 4 | 40,M | Uricaria,tongue swelling | 0.47–0.90 | (11–25) | Yes | Piperacillin/tazobactam | - | 12 Step, 250 mL bag | 1 | No | — | Yes |
| 12 Step, 250 mL bag | 1 | Step 3: Urticaria,sore throat | Diphenhydramine | Yes | ||||||||
| 12 Step, 250 mL bag | 1 | Step 12: Urticaria | Diphenhydramine | Yes | ||||||||
| 12 Step, 250 mL bag | 1 | Step 12: Urticaria | Diphenhydramine, methylprednisolone | Yes | ||||||||
| 13 Step, 250 mL bag | 1 | No | — | Yes | ||||||||
| Uricaria,angioedema | 0.79 | (20) | Ceftazidime | nd | 12 Step, 250 mL bag | 1 | No | — | Yes | |||
| 16 Step, 100 mL bag | 1 | No | — | Yes | ||||||||
| 5 | 22,F | Urticaria,throat swelling | 1.17 | (31) | Yes | Ceftazidime | nd | 16 Step, 100 mL bag | 2 | No | — | Yes |
| Uricaria | N/A | TMP/SMX | nd | 16 Step, 100 mL bag | 1 | No | — | Yes | ||||
| 6 | 35,F | Urticaria,throat pruritus | 2.32 | (77) | No | Ceftazidime | + | 12 Step, 250 mL bag | 1 | No | — | Yes |
| Uricaria,lip swelling | 1.66–2.10 | (56–72) | Cefepime | nd | 16 Step, 20 mL bag | 3 | No | — | Yes | |||
| 12 Step, 50 mL bag | 3 | No | — | Yes | ||||||||
| 7 | 21,F | Urticaria | 1.55 | (49) | No | Cefoxitin | nd | 12 Step, 250 mL bag | 1 | No | — | Yes |
| 8 | 42,M | Urticaria | 1.52 | (38) | No | Ceftazidime | - | 12 Step, 100 mL bag | 1 | No | — | Yes |
| 9 | 21,F | Urticaria | 1.72–1.84 | (54–58) | No | Piperacillin/tazobactam | + | 16 Step, 100 mL bag | 1 | Nausea,diarrhea flushing,erythema 2 | Diphenhydramine | Yes |
| 12 Step, 250 mL bag | 1 | No | — | Yes | ||||||||
| 16 Step, 100 mL bag | 1 | Urticaria,flushing 2 | Diphenhydramine | Yes | ||||||||
| 10 | 26,M | Urticaria | 1.11–2.02 | (27–47) | Yes | Ceftazidime | nd | 12 Step, 100 mL bag | 4 | No | — | Yes |
| 12 Step, 100 mL bag | 1 | Acute respiratory failure 2 | Intubation | Yes | ||||||||
| 12 Step, 250 mL bag | 2 | No | — | Yes | ||||||||
| 12 Step, 100 mL bag | 1 | No | — | Yes | ||||||||
| Urticaria,dyspnea,wheezing | 1.11–2.02 | (27–47) | Piperacillin/tazobactam | - | 12 Step, 250 mL bag | 2 | No | — | Yes | |||
| 12 Step, 100 mL bag | 2 | No | — | Yes | ||||||||
| 11 | 25,F | Urticaria | 1.81 | (51) | No | Tobramycin | nd | 12 Step, 200mL bag | 1 | No | — | Yes |
| Urticaria | 1.81 | (51) | Meropenem | nd | 12 Step, 100 mL bag | 1 | No | — | Yes | |||
| 12 | 26,M | Urticaria | 1.50–2.80 | (32–61) | No | Ceftazidime | + | 12 Step, 250 mL bag | 2 | No | — | Yes |
| 12 Step, 250 mL bag | 1 | Step 12: Urticaria | Diphenhydramine | Yes | ||||||||
| 13 | 29,M | Urticaria | 2.83 | (65) | No | Ciprofloxacin | nd | 12 Step, 250 mL bag | 2 | No | — | Yes |
| 14 | 22,F | Urticaria | 1.70 | (60) | No | Piperacillin/tazobactam | - | 12 Step, 250 mL bag | 1 | No | — | Yes |
| 15 3 | 49,F | Urticaria, scratchy throat | 1.50 | (49–50) | No | Ceftazidime | nd | 12 Step, 100 mL bag | 3 | No | — | Yes |
| Urticaria,wheezing | 1.50 | (49) | TMP/SMX | nd | 12 Step, 500mL bag | 1 | No | — | Yes | |||
N/A : Not available (immediately post-transplant)
nd : Not done
1
Desensitized once during lung transplant
2
Reaction after step 12 and prior to first full dose
3
Anaphylactic reaction to Amoxicillin : sudden onset of rash and throat swelling requiring a visit to the emergency room and epinephrine