Occupational Asthma Reference

Davies RJ, Hendrick DJ, Pepys J, Asthma due to inhaled chemical agents: ampicillin,benzyl penicillin, 6 amino penicillanic acid and related substances, Clin Allergy, 1974;4:227-247,

Keywords: oa, as , ch, case report, pharmaceutical, ampicillin, penicillin, ur, tr, oc, nc

Known Authors

Jack Pepys, Royal Brompton Hospital Jack Pepys

David Hendrick, Newcastle-upon-Tyne David Hendrick

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Three out of four workers from an antibiotic-producing factory developed late asthma and eosinophilia on inhalation challenge testing with ampicillin and related substances. The chemicals to which each worker reacted varied, suggesting differences in the clinically important allergens for each individual.

The taking by mouth of ampicillin in one patient, and benzyl penicillin in another in therapeutic doses led to the development of late asthma accompanied by skin and gastro-intestinal disturbances.

The inhalation of 200 µg of beclomethasone dipropionate before in one case, and before and 3-hourly after provocation challenge in the other, blocked the late asthmatic reaction. 40 mg sodium cromoglycate similarly given failed to inhibit the reactions. In one patient, 04416–0.24 mg of isoprenaline sulphate inhaled 10 min before or 60 min after inhalation testing prevented the development of late asthma, and when given during the asthmatic reaction led to its rapid reversal.

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