Abstract
In the process of reviewing a large number of drug eruptions reported in Japan during the last six years, from 1984 to 1989, we have identified a hitherto unrecognized subset related to prodrugs, in whose subset the patients with eruptions related to prodrugs developed a positive reaction to a patch test (PT) and/or lymphocyte stimulating test (LST) for the prodrugs being taken as well as for the active final products of the prodrugs. Six reported patients with bacampicillin (BAPC) related drug eruptions in which PT and/or LST were done as a diagnostic aid, developed a positive reaction not only for BAPC itself but also for ampicillin (ABPC), and tarampicillin (TAPC) as well. While these findings were reported as a cross reaction among these antibiotics, from the point of view that both BAPC and TAPC are the prodrugs of ABPC, it seems conceivable that BAPC is much less responsible for the eruptions than ABPC, which is produced from these prodrugs during the absorption process into the digestive tract and thus is present in the blood stream in vivo.
