Source: International Congress 2014 – Clinical allergy
Disease area: Airway diseases

Abstract

We reported one case of severe asthmatic attack with cardiac arrest suspected to be induced by sulbactam sodium. A 74-year-old female received intravenous administration of mezlocillin sodium/sulbactam sodium for pulmonary infection complicated by bronchial asthma. After infusion of about 10 ml, the patient suddenly developed severe asthmatic attack and palpitations, then apnea and cardiac arrest. The patient was successfully rescued by glucocorticoids treatment and cardiopulmonary resuscitation. The above symptoms were considered to be caused by mezlocillin sodium/sulbactam sodium. Detailed investigation showed that the patient's past allergy history was significant for allergy to cefoperazone/sulbactam sodium. However, she was ever administered cefoperazone, penicillin, piperacillin/tazobactam intravenously without allergic reaction. We suspected the patient was allergic to sulbactam sodium. After the patient recovered completely, the intracutaneous susceptibility test of 0.9% sodium chloride, penicillin, sulbactam sodium was performed. The result of the former two agents was negative, but that of sulbactam sodium was positive. To our knowledge, this is the first report of life-threatening allergy probably induced by sulbactam sodium. Clinicians are usually cautious of allergy to penicillin and cephalosporins but ignore allergy to b-lactamase inhibitors. If a patient has a past history of allergy to compound antimicrobial agents, possible allergy to b-lactamase inhibitors should also be considered. In such a patient, the intracutaneous susceptibility test of the two preparations should be performed respectively for fear of possible serious outcomes.

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Citations should be made in the following way:
W. Zheng, Y. Chen, L. Zhao (Shenyang, China). Severe asthmatic attack with cardiac arrest suspected to be induced by sulbactam sodium. Eur Respir J 2014; 44: Suppl. 58, 4024

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