engleski

Occupational allergic contact dermatitis from azithromycin in pharmaceutical workers: a case series

Background: Reports on hypersensitivity reactions to azithromycin associated with therapy or occupational exposure have been rare. Objectives: A case series which describes clinical characteristics, diagnostic patways and risk factors in occupational allergic contact dermatitis (ACD) caused by azithromycin in pharmaceutical workers. Patients/Methods: Seven out of 21 pharmaceutical workers exposed to powdered intermediate and final substances in azithromycin synthesis were referred with workplace related skin and respiratory symptoms. They all underwent diagnostic procedure involving medical history and examination, patch testing with standard allergens and azithromycin, prick testing with inhalatory allergens, and total IgE measurement. Results: Airborne ACD caused by azithromycin was established in four examined workers with positive patch test to azithromycin. Two had additionally positive patch test to intermediate substances. Occupationally related symptoms of urticaria, rhinoconjunctivitis, laryngitis and/or dyspnea were described in additional two workers without clearly positive patch test to azithromycin. Two atopic workers had a shorter asymptomatic period between the beginning of the exposure to azithromycin and occurrence of skin symptoms than non-atopics (2-3 months vr. 1-3 years, respectively). Conclusions: Our results suggest that daily manipulation with powdered azithromycin and intermediates is a main route of sensitization. Beside contact sensitization, other possible workplace-related azithromycin hypersensitivity reactions are indicated.

allergic contact dermatitis ; azithromycin ; hypersensitivity ; occupational exposure to pharmaceuticals

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