Table 3: IgE Reactivity and cross-linking by non-covalent
drug-carrier complexes
- Positive skin prick tests (SPT, within 15 min) to
amoxicillin, cefuroxim, etc., before covalent drug-carrier complexes
are formed
- 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)
- 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
- Anaphylaxis with mast cell degranulation to drugs occurs
<5 min after injection, before covalent links can be formed