Enhancing Effects of Fluorescein on β‐Lactam Rash II: Enhancing Effects of Fluorescein on Generalized Rash Induced by β‐Lactam Antibiotics in Guinea Pigs

Abstract

Healthy volunteers, who were receiving intravenous injections of cefclidin (CFCL) with frequent concomitant use of fluorescein (F) and oxybuprocain (O) in the eyes for measurement of ocular tension, developed drug eruptions at the high frequency of 66.7%. The injection of CFCL alone induced the eruptions at an incidence of 2.8%. The cause of this high eruption rate was thought to be the simultaneous treatment with F and/or O. Therefore, we conducted experiments with CFCL-induced generalized rash (GR) in guinea pigs. Guinea pigs treated with F and O during both the phases of immunization and intraperitoneal elicitation developed CFCL rashes at a high frequency. This CFCL-rash was augmented by the treatment with F during either phase, but not by the treatment with O. Skin testing induced delayed type hypersensitivity (DTH) reaction to O in some animals, but the DTH to F was not induced in animals immunized with F in complete Freund's adjuvant. Furthermore, F augmented rashes induced not only by CFCL but also by other beta-lactam antibiotics such as cefsulodin and sulbenicillin. Accordingly, it is likely that F played a dominant role in the high incidence of drug eruptions during the volunteer trials with measurement of ocular tension.

Periorbital allergic contact dermatitis from oxybuprocaine

“…2 cases of immediate‐type hypersensitivity reactions have previously been reported (8, 9). To our knowledge, except in the guinea pig (10), no delayed‐type hypersensitivity reaction has previously been described. In patient no.…”

Enhancing Effects of Fluorescein on β‐Lactam Rash I: High Incidence of Cefclidin Rashes in an Ophthalmological Volunteer Trial

“…We have observed that fluorescein enhanced the incidence and the intensity of generalized rashes induced by 13-lactam antibiotics in guinea pigs. These data will be presented and discussed in the following paper (8).…”

Nicergorine‐induced Lichen Planus‐like Eruption

“…Since the skin lesion developed when nicergorine was administered along with the six other kinds of drugs, drug interactions might have played a role in the devleopment of the eruption. For instance, the enhancing effects of fluorescein on generalized rashes induced by ,B-Iactam antibiotics were reported in an animal model (6).…”