Successful desensitization to colistin in a Peruvian patient with cystic fibrosis

Authors

  • Liz Veramendi-Espinoza Servicio de Alergia. Hospital Nacional Edgardo Rebagliati Martins. Lima-Perú
  • Vladimir Espinoza-Ildefonso Servicio de Infectología. Hospital Nacional Edgardo Rebagliati Martins. Lima-Perú
  • Joel Calero Herrera Servicio de Alergia. Hospital Nacional Edgardo Rebagliati Martins. Lima-Perú
  • Juan Carlos Aldave Becerra Servicio de Alergia. Hospital Nacional Edgardo Rebagliati Martins. Lima-Perú

DOI:

https://doi.org/10.35434/rcmhnaaa.2023.162.1706

Keywords:

Cystic Fibrosis, Drug Hypersensitivity, Anti-Bacterial Agents, Colistin, Precision Medicine

Abstract

Introduction: Pharmacological desensitization induces a temporary hyposensitivity to the causative drug in patients with Immunoglobulin E-mediated drug reactions. Case of report: We present the case of a patient with respiratory exacerbation of cystic fibrosis who presented immediate hypersensitivity to colistin, an essential antibiotic for its treatment—both due to the sensitivity of the microorganism and the lack of availability of other drugs. The procedure was successfully performed in the Intensive Care Unit, and the patient completed the treatment schedule. Conclusion: Currently, the patient is undergoing specific treatment for his underlying disease and has not presented any new episodes of exacerbation or pneumonia.

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Author Biographies

Liz Veramendi-Espinoza, Servicio de Alergia. Hospital Nacional Edgardo Rebagliati Martins. Lima-Perú

1. Médico especialista en Inmunología y Alergia

Vladimir Espinoza-Ildefonso, Servicio de Infectología. Hospital Nacional Edgardo Rebagliati Martins. Lima-Perú

1. Médico especialista en Infectología y Medicina Tropical

Joel Calero Herrera, Servicio de Alergia. Hospital Nacional Edgardo Rebagliati Martins. Lima-Perú

1. Médico especialista en Inmunología y Alergia

Juan Carlos Aldave Becerra, Servicio de Alergia. Hospital Nacional Edgardo Rebagliati Martins. Lima-Perú

1. Médico especialista en Inmunología y Alergia

References

Anstey KM, Lee M, Dawson D, Jue V, Budzik JM, Yu M, et al. Antibiotic adverse reactions in adult cystic fibrosis patients. J Allergy Clin Immunol Pract. 2020;8(10):3631-33.e1. doi: 10.1016/j.jaip.2020.06.060

Eyns H, Piérard D, De Wachter E, Eeckhout L, Vaes P, Malfroot A. Respiratory Bacterial Culture Sampling in Expectorating and Non-expectorating Patients With Cystic Fibrosis. Front Pediatr. 2018;6:403. doi: 10.3389/fped.2018.00403

Petroni DH, Aitken ML, Ham E, Chung S, Menalia L, Altman MC, et al. Approach to the evaluation of adverse antibiotic reactions in patients with cystic fibrosis. Ann Allergy Asthma Immunol. 2016;117(4):378–81. doi: 10.1016/j.anai.2016.07.039

Tugcu GD, Emiralioglu N, Yalcin E, Sahiner UM, Dogru D, Sekerel BE, et al. The controversy of drug hypersensitivity in patients with cystic fibrosis and review of the literature. Pediatr Allergy Immunol. 2022;33(2):e13719. doi: 10.1111/pai.13719.

Braun C, Reix P, Durieu I, Nove-Josserand R, Durupt S, Ohlmann C, et al. The diagnosis of hypersensitivity to antibiotics is rarely confirmed by allergy work-up in cystic fibrosis patients. Pediatr Allergy Immunol. 2020;31(4):396–404. doi: 10.1111/pai.13206.

Anstey KM, Choi L, Dawson D, Kleinhenz ME, Otani IM. Enabling antibiotic allergy evaluations and reintroduction of first-line antibiotics for patients with cystic fibrosis. Ann Allergy Asthma Immunol. 2021;127(4):456–61. doi: 10.1016/j.anai.2021.05.022.

Tosi MF, Konstan MW, Paschall VL. Rapid intravenous desensitization to colistin. Ann Allergy Asthma Immunol. 2012;109(5):361–2. doi: 10.1016/j.anai.2012.08.006.

Süleyman A, Tamay Z, Güler N. Antibiotic allergy in children with cystic fibrosis: A retrospective case-control study. Pediatr Pulmonol. 2022; doi: 10.1002/ppul.26073.

Stan RC. Temporal Modulation of Drug Desensitization Procedures. Curr Issues Mol Biol. 2022;44(2):833–44. doi: 10.3390/cimb44020057.

Rukasin CRF, Norton AE, Broyles AD. Pediatric Drug Hypersensitivity. Curr Allergy Asthma Rep. 2019;19(2):11. doi: 10.1007/s11882-019-0841-y.

Rigg L, Wu SS, Hull D, Hostoffer RW. A revision of rapid colistin desensitization. Ann Allergy Asthma Immunol. 2019;123(6):607–8. doi: 10.1016/j.anai.2019.09.012.

Sieber J, Renner S, Lakatos-Krepcik A, Szépfalusi Z. Case Report: Maintenance of Desensitization to Nebulized Colomycin Over 10 Years. Front Pediatr. 2021;9:663228. doi: 10.3389/fped.2021.663228.

Scotet V, L’Hostis C, Férec C. The Changing Epidemiology of Cystic Fibrosis: Incidence, Survival and Impact of the CFTR Gene Discovery. Genes (Basel). 2020;11(6):589. doi: 10.3390/genes11060589.

Fiqui Perú. Información general [Internet]. 2020 [citado el 3 de agosto de 2022]. Disponible en: https://www.fiqui.org.pe/

Castells MC. Drug Hypersensitivity and Desensitizations. Immunol Allergy Clin North Am. 2017;37(4):17–8. doi: 10.1016/j.iac.2017.08.002.

Published

2023-06-22

How to Cite

1.
Veramendi-Espinoza L, Espinoza-Ildefonso V, Calero Herrera J, Aldave Becerra JC. Successful desensitization to colistin in a Peruvian patient with cystic fibrosis. Rev. Cuerpo Med. HNAAA [Internet]. 2023 Jun. 22 [cited 2024 Nov. 23];16(2). Available from: https://cmhnaaa.org.pe/ojs/index.php/rcmhnaaa/article/view/1706