Abstract
Among 18 patients studied shortly after experiencing systemic reactions to penicillin, skin sensitizing antibodies were detected by passive transfer tests with a solution of potassium penicillin G in all but one. In this single exception, serum reagins were demonstrated for an altered penicillin compound, produced by the incubation of procaine or potassium penicillin G in the presence of sodium carboxymethylcellulose, a component of a diluent employed in the manufacture of aqueous procaine penicillin suspension. Another diluent component, sodium citrate, also proved capable, although to a lesser degree, of altering procaine penicillin to a form which reacted with the patient's serum. It had no such effect on potassium penicillin. Reagins for altered penicillin compounds as demonstrated in this study will undoubtedly account for some of the reports of patients who suffered immediate systemic reactions to penicillin but were said to show negative skin reactions to tests with potassium penicillin.
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