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538 patients, admitted to the hospitals participating in this study for a variety of indications for antibacterial therapy, were treated by the ampicillin-analogue Epicillin. 42 patients (7.8%) who developed exanthem underwent detailed clinical and immunological investigation. Exanthems were scored according to the form of application and doses of Epicillin as well as to the morphology and time of onset of the exanthem. A variety of serological tests were performed: 1. total IgE (RIST), 2. presence of penicilloyl-specific IgE (RAST), 3. penicilloyl-reactive antibodies using an antiglobulin-haemagglutination-tests. In addition, PHA-induced lymphocyte transformation was studied in 10 patients with exanthems. 38/42 patients developed transient monomorphic morbiliform or scarlatiniform exanthems. 4. exanthems were classified as urticarial or polymorphic. In contrast to the 38 patients, the latter also were positive in the serological tests as it is observed in patients with IgE-mediated penicillin allergy.
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