Non-IgE Mediated Reactions

Gastrointestinal Intolerance

Nausea, vomiting, and diarrhea, are frequently associated with antimicrobial use and do not preclude future use

Gastrointestinal adverse events can be limited by administering the antimicrobial with food, using the lowest effective dose and the shortest possible duration for the given indication

Maculopaular Rashes

Common with beta-lactam use (especially with aminopenicillins and cephalosporins) and are often caused by a viral interaction (e.g. EBV)

These usually occur greater than 72 hours after exposure and are non-uriticarial

They are not IgE-mediated and do not constitute a contraindication to further beta-lactam therapy

Other Serious Systemic or Organ Specific Adverse Events

If a particular antimicrobial is associated with the development of these symptoms, it is then contraindicated for future use:

Interstitial nephritis

Haemolytic anemia

Serum sickness

Other serious cutaneous reactions (e.g. Stevens - Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN), Exfoliative Dermatitis)

Drug reaction with eosinophilia and systemic symptoms (DRESS)