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May 6, 20260 citationsOpen Access

A Review of Antibiotic-Induced Drug Allergies: Mechanisms, Prevalence, and Future Perspectives

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GSGhassan ShannanZMZeina S MalekNTNasser Thallaj

Key Points

  • This review synthesizes current knowledge on antibiotic-induced allergies and identifies knowledge gaps.
  • Review of existing literature on antibiotic-induced drug allergies
  • Discussion of mechanisms such as haptenization and pharmacologic interactions
  • Analysis of diagnostic challenges in identifying true allergic responses
  • Highlights the prevalence of allergic reactions to antibiotics like sulfamethoxazole
  • Emphasizes the role of immune responses and hypersensitivity reactions
  • Identifies challenges in differentiating adverse drug effects from allergies

Abstract

Drug allergies pose a significant public health challenge, contributing to a substantial proportion of adverse drug reactions, particularly among antibiotics. This review explores the mechanisms underlying drug allergies, emphasizing the role of antibiotics, which frequently induce hypersensitivity reactions. Drug allergies are classified into immediate and delayed hypersensitivity types, with immediate reactions mediated by immunoglobulin E (IgE) and delayed responses involving T lymphocytes. A critical aspect of antibiotic-induced allergies is haptenization, where antibiotics interact with host proteins, forming antigenic determinants that trigger immune responses. Recent studies highlight the prevalence of allergic reactions to specific antibiotics, such as amoxicillin and sulfamethoxazole, raising concerns regarding their clinical use and management. The review examines the emerging pharmacologic interaction (p-i) concept, which suggests that certain antibiotics may activate T lymphocytes directly without requiring haptenization. Additionally, the diagnostic challenges associated with distinguishing true allergic reactions from adverse drug effects are discussed, emphasizing the need for more sensitive and specific testing methods. This review aims to synthesize current knowledge on antibiotic-induced allergies, identify gaps in understanding, and propose future research directions. By enhancing our understanding of the immunological mechanisms involved, this work seeks to improve diagnostic and therapeutic strategies, ultimately contributing to better patient safety and care in clinical settings. Original Article: https: //www. researchgate. net/profile/Ghassan-Shannan/publication/390695383AREVIEWOFANTIBIOTIC-INDUCEDDRUGALLERGIESMECHANISMSPREVALENCEANDFUTUREPERSPECTIVES/links/67f926debfbe974b23a8ea0a/A-REVIEW-OF-ANTIBIOTIC-INDUCED-DRUG-ALLERGIES-MECHANISMS-PREVALENCE-AND-FUTURE-PERSPECTIVES. pdf? origin=publicationdetail&ₜp=eyJjb250ZXh0Ijp7ImZpcnN0UGFnZSI6InB1YmxpY2F0aW9uIiwicGFnZSI6InB1YmxpY2F0aW9uRG93bmxvYWQiLCJwcmV2aW91c1BhZ2UiOiJwdWJsaWNhdGlvbiJ9fQ&_cfchlₜk=QLV9MRY8J6r6. Dfl0cQUikE64WZ0PG2ptqkza2TRqUw-1777877716-1. 0. 1. 1-ZHjcD665igF3kvTsbwZEsOblLaAsTPUDgtrXn6ybEThis version is archived in the Arab International University (AIU) repository for open access and dissemination purposes. The content of this paper has not been modified from the original publication. For more information, please visit the official repository of Arab International University (AIU): https: //aiu. edu. sy

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Cite This Study

Shannan et al. (2025) studied this question.

synapsesocial.com/papers/69faa28f04f884e66b5331echttps://doi.org/10.5281/zenodo.20022100
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A REVIEW OF ANTIBIOTIC-INDUCED DRUG ALLERGIES: MECHANISMS, PREVALENCE, AND FUTURE PERSPECTIVES2025
  2. 2Antibiotic Hypersensitivity: Classification, Mechanisms, Signs, and Diagnostic Approaches: A Critical Review2025
  3. 3Global Burden of Drug‐Induced Anaphylaxis Associated With 33 Classes of Antibiotics (1968–2024): A Pharmacovigilance Analysis2025 · 3 citations
  4. 4Antibiotic allergy: Mislabels, Misinterpretation and Mismanagement2024
  5. 5Availability and Efficacy of Assessment Strategies for Delabelling of Antibiotic Allergies, and the Role of the Pharmacist.2023