Anaphylactic reactions to topical rifamycin

Allergic contact dermatitis to topical antibiotics: Epidemiology, responsible allergens, and management

“…Rifamycin has also been reported to cause anaphylaxis after the use of an eyedrop and when applied to postsurgical or to other wounds. 160,182 Knowles et al 185 reported a case of type IV hypersensitivity reaction to intravaginal metronidazole followed by a type I hypersensitivity reaction to oral metronidazole. A 35-year-old female had previously experienced localized erythema to intravaginal metronidazole.…”

“…Rifamycin is used topically for the treatment of infectious conjunctivitis, infected wounds, and for some leg ulcers. 160 Riboldi et al 161 published the first case of rifamycin contact allergy in an 11-year-old boy who developed dermatitis after applying a topical medicine containing rifamycin and mercurochrome to minor wounds. The boy had positive patch test reactions to rifamycin and mercurochrome (concentrations not reported).…”

“…Prick or scratch testing is most commonly used to diagnose type I hypersensitivity. Table IV 108,160, lists topical antibiotics known to cause immediate reactions. In all but one reported case, an interruption of the skin barrier was present.…”

Hypersensitivity Reactions to Ophthalmic Products

“…A few cases of contact dermatitis have been reported [59][60][61][62][63], while, to the best of our knowledge, there is only one report of a systemic reaction after application of eye drops containing rifamycin. A 36-year-old non-atopic woman had developed intense ocular pruritus and eyelid angioedema immediately following the administration of rifamycin on the fourth day of treatment [64]. Twenty-four hours later she had suffered a generalized urticaria that gradually disappeared upon discontinuing the eye drops.…”

Multiple Drug Allergy Syndrome: severe anaphylactic reaction due to topical Rifamycin SV in a patient with hypersensitivity to ciprofloxacin

“…We report an immediate adverse reaction probably triggered by the systemic absorption of topically administered rifamycin in a patient with hypersensitivity to ciprofloxacin. Allergic reaction to quinolones and rifamycin are uncommon, but several reports have described anaphylactic reaction 1,2 contact urticaria 3,4 or delayed contact dermatitis 5 after topical application of rifamycin. Adverse reaction to either ciprofloxacin or rifampicin (a semisynthetic derivative of rifamycin used in tuberculosis therapy, involved in several cases of allergic reaction) 6,7 was previously described in five HIV‐infected patients 8 .…”