Table 3: IgE Reactivity and cross-linking by non-covalent drug-carrier complexes
  1. Positive skin prick tests (SPT, within 15 min) to amoxicillin, cefuroxim, etc., before covalent drug-carrier complexes are formed
  2. Positive SPT/i.d. tests to drugs (15 min) like sulfamethoxazole, which per se does not form covalent bonds; SMX needs metabolism to generate reactive metabolites (SMX-NO), which needs > 6-10 h (13)
  3. Positive BAT to drugs: it occurs fast, before covalent bonds are formed (amoxicillin, cefuroxim, etc.) or reactive metabolites (e.g. SMX-NO) are generated in the in- vitro conditions
  4. Anaphylaxis with mast cell degranulation to drugs occurs <5 min after injection, before covalent links can be formed