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beta-lactam allergy

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https://www.readbyqxmd.com/read/29047169/non-immediate-reading-skin-tests-and-prolonged-challenges-in-non-immediate-hypersensitivity-to-beta-lactams-in-children
#1
G Lezmi, F Alrowaishdi, A Bados-Albiero, P Scheinmann, J de Blic, C Ponvert
BACKGROUND: A minority of children reporting non-immediate reactions to beta-lactams (BLs) are allergic. Allergy workup usually includes late-reading (48-72h) skin tests (ST) and short (1-3 days) drug provocation tests (DPT), regardless of the chronology of the index reaction. The sensitivity of hyper-late-reading (≥ 6-7 days) ST and of prolonged DPT for the diagnosis of non-immediate hypersensitiviy to BLs are yet to be determined. OBJECTIVES: To establish the diagnostic values of late- and hyper-late-reading ST and of prolonged DPT in children reporting non-immediate reactions to BLs...
October 19, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28965636/management-of-children-with-hypersensitivity-to-antibiotics-and-monoclonal-antibodies
#2
REVIEW
Allison Eaddy Norton, Ana Dioun Broyles
Proper management of drug allergy in children is based on a thorough history, in vitro testing (if available), in vivo testing, and drug challenge. This approach has been well developed with beta-lactam drugs but not with non-beta-lactam drugs and monoclonal antibodies. Children commonly develop rashes during an antibiotic course, which can lead to misdiagnosis of drug allergy. Clinical reactions to monoclonal antibodies vary and are managed depending on the type. A better knowledge of drug reactions that can occur in antibiotic allergy and monoclonal allergy can aid a provider in better management of their drug-allergic pediatric patients...
November 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28965632/penicillin-and-beta-lactam-hypersensitivity
#3
REVIEW
Daniel Har, Roland Solensky
Ten percent of patients report penicillin allergy, but more than 90% of these individuals can tolerate penicillins. Skin testing remains the optimal method for evaluation of possible IgE-mediated penicillin allergy and is recommended by professional societies, as the harms for alternative antibiotics include antimicrobial resistance, prolonged hospitalizations, readmissions, and increased costs. Removal of penicillin allergy leads to decreased utilization of broad-spectrum antibiotics, such as fluoroquinolones and vancomycin...
November 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28964705/use-of-the-basophil-activation-test-may-reduce-the-need-for-drug-provocation-in-amoxicillin-clavulanic-allergy
#4
María Salas, Rubén Fernández-Santamaría, Cristobalina Mayorga, Esther Barrionuevo, Adriana Ariza, Teresa Posadas, Jose Julio Laguna, María Isabel Montañez, Noemi Molina, Tahia Diana Fernández, María José Torres
BACKGROUND: Reports of selective reactions to clavulanic acid (CLV) have increased in recent decades because of its increased prescription in combination with amoxicillin (AX) as AX-CLV. Basophil activation test (BAT) is used for diagnosing beta-lactam immediate hypersensitivity and is the only available in vitro assay for diagnosing patients with immediate hypersensitivity to CLV. However, few studies, and with limited numbers of patients have been published. OBJECTIVE: The aim of this study was to establish the sensitivity, specificity, and negativization rates of BAT to AX and CLV...
September 27, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28911283/australian-and-new-zealand-anaesthetic-allergy-group-perioperative-anaphylaxis-investigation-guidelines
#5
R J Scolaro, H M Crilly, E J Maycock, P T McAleer, K A Nicholls, M A Rose, Rih The
These guidelines are a consensus document developed by a working party of the Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) to provide an approach to the investigation of perioperative anaphylaxis. They focus primarily on the use of skin testing as it is the investigation with the greatest clinical utility for the identification of the likely causative agent and potentially safer alternatives. The practicalities and process of skin testing, its limitations, and the place of other tests are discussed...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28888247/fatal-anaphylaxis-mortality-rate-and-risk-factors
#6
Paul J Turner, Elina Jerschow, Thisanayagam Umasunthar, Robert Lin, Dianne E Campbell, Robert J Boyle
Up to 5% of the US population has suffered anaphylaxis. Fatal outcome is rare, such that even for people with known venom or food allergy, fatal anaphylaxis constitutes less than 1% of total mortality risk. The incidence of fatal anaphylaxis has not increased in line with hospital admissions for anaphylaxis. Fatal drug anaphylaxis may be increasing, but rates of fatal anaphylaxis to venom and food are stable. Risk factors for fatal anaphylaxis vary according to cause. For fatal drug anaphylaxis, previous cardiovascular morbidity and older age are risk factors, with beta-lactam antibiotics, general anesthetic agents, and radiocontrast injections the commonest triggers...
September 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28844171/a-clinical-decision-making-algorithm-for-penicillin-allergy
#7
Angèle Soria, Elodie Autegarden, Emmanuelle Amsler, Hafida Gaouar, Amandine Vial, Camille Francès, Jean-Eric Autegarden
BACKGROUND: About 10% of subjects report suspected penicillin allergy, but 85-90% of these patients are not truly allergic and could safely receive beta-lactam antibiotics Objective: To design and validate a clinical decision-making algorithm, based on anamnesis (chronology, severity, and duration of the suspected allergic reactions) and reaching a 100% sensitivity and negative predictive value, to assess allergy risk related to a penicillin prescription in general practise. STUDY DESIGN AND METHODS: All patients were included prospectively and explorated based on ENDA/EAACI recommendations...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28829234/proactive-penicillin-allergy-testing-in-primary-care-patients-labeled-as-allergic-outcomes-and-barriers
#8
Britta K Sundquist, Brady J Bowen, Uwa Otabor, Jocelyn Celestin, Paul C Sorum
OBJECTIVES: To promote penicillin allergy testing in an outpatient setting in patients labeled as penicillin allergic, to determine the number of those who are truly allergic, evaluate patient satisfaction with the testing, and educate both patients and clinicians about testing. METHODS: Patients with a history of penicillin allergy listed in their EHR were screened and recruited by their primary care office and referred for penicillin allergy testing. The results of allergy testing and patient satisfaction after testing were the main outcomes...
August 24, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28814358/frequency-of-selective-immediate-responders-to-aminopenicillins-and-cephalosporins-in-turkish-children
#9
Emine Dibek Misirlioglu, Hakan Guvenir, Muge Toyran, Emine Vezir, Murat Capanoglu, Ersoy Civelek, Betul Buyuktiryaki, Tayfur Ginis, Can Naci Kocabas
BACKGROUND: Beta-lactam antibiotics (BLA) are the most commonly prescribed antibiotics and are responsible for the majority of immediate hypersensitivity reactions to drugs in children. Cross-reactivity is important in hypersensitivity to BLAs because these drugs all share a common beta-lactam structure and some share similar side chains. OBJECTIVE: The aim of this study was to evaluate the clinical characteristics of patients who are diagnosed with immediate-type BLA hypersensitivity and frequency of patients with side chain hypersensitivity, "selective responders...
September 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28754229/-hypersensitivity-reactions-to-beta-lactam-antibiotics
#10
E Amsler, A Soria
Allergy to beta-lactam antibiotics is a common condition and about 10% of patients report being allergic to penicillin. However, this diagnosis is largely overestimated. Two types of allergy should be distinguished and include immediate hypersensitivity that can lead to anaphylactic shock and delayed hypersensitivity, ranging from the most common maculopapular exanthema to severe bullous toxidermia or life-threatening DRESS. Allergy challenge with oriented skin tests according to the clinical features, supplemented with oral challenge in the absence of contraindication, will confirm or invalidate the diagnosis of beta-lactam allergy and will help to identify if necessary safe alternatives to beta-lactams...
November 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28752367/update-on-quinolone-allergy
#11
REVIEW
Inmaculada Doña, Esther Moreno, Natalia Pérez-Sánchez, Inmaculada Andreu, Dolores Hernández Fernandez de Rojas, María José Torres
PURPOSE OF REVIEW: Quinolones are a group of synthetic antibiotics widely use as first-line treatment for many infections. There has been an increase in the incidence of hypersensitivity reactions to quinolones in recent years, likely due to increased prescription. The purpose of this review is to summarize the clinical pictures, the methods used for diagnosing and the management of allergic reactions to quinolones. RECENT FINDINGS: Allergic reactions to quinolones can be immediate or delayed, being anaphylaxis and maculopapular exanthema respectively the most frequent clinical entities...
August 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28742538/anaphylaxis-and-intimate-behaviour
#12
Gennaro Liccardi, Marco Caminati, Gian Enrico Senna, Luigino Calzetta, Paola Rogliani
PURPOSE OF REVIEW: Intimate behaviours may represent an unusual way of exposure to a culprit allergen, or the frame for sex-related allergies due to triggers typically linked to that situation. The present review aims at summarizing the state of the art about the topic, in order to spread the awareness and the basic know-how in the field of sexual-related allergies. RECENT FINDINGS: Kiss-related IgE-mediated reactions are caused in sensitized partners mainly by the passive transport of allergenic molecules through saliva, skin or oral mucosa...
July 22, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28739365/designing-predictive-models-for-beta-lactam-allergy-using-the-drug-allergy-and-hypersensitivity-database
#13
Anca Mirela Chiriac, Youna Wang, Rik Schrijvers, Philippe Jean Bousquet, Thibault Mura, Nicolas Molinari, Pascal Demoly
BACKGROUND: Beta-lactam antibiotics represent the main cause of allergic reactions to drugs, inducing both immediate and nonimmediate allergies. The diagnosis is well established, usually based on skin tests and drug provocation tests, but cumbersome. OBJECTIVES: To design predictive models for the diagnosis of beta-lactam allergy, based on the clinical history of patients with suspicions of allergic reactions to beta-lactams. METHODS: The study included a retrospective phase, in which records of patients explored for a suspicion of beta-lactam allergy (in the Allergy Unit of the University Hospital of Montpellier between September 1996 and September 2012) were used to construct predictive models based on a logistic regression and decision tree method; a prospective phase, in which we performed an external validation of the chosen models in patients with suspicion of beta-lactam allergy recruited from 3 allergy centers (Montpellier, Nîmes, Narbonne) between March and November 2013...
July 21, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28724882/using-%C3%AE-lactam-antibiotics-in-patients-with-a-history-of-%C3%AE-lactam-allergy-current-concepts
#14
Esther Moreno, Elena Laffond, Francisco Javier Muñoz-Bellido, María Teresa Gracia, Eva María Macías, Ignacio Dávila
β-lactams are the most widely used antibiotic family, but they are also the most common cause of drug-induced hypersensitivity reactions. The estimated prevalence of reported penicillin allergy ranges between 9% and 12%, although a high percentage of patients with a history of penicillin allergy have no subsequent reactions on reexposure to β-lactams. A self-reported penicillin allergy has been associated with antimicrobial resistance, increased cost, intensive care admission, and death, making it essential to establish an accurate diagnosis...
August 9, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28575226/point-of-care-beta-lactam-allergy-skin-testing-by-antimicrobial-stewardship-programs-a-pragmatic-multicenter-prospective-evaluation
#15
Jerome A Leis, Lesley Palmay, Grace Ho, Sumit Raybardhan, Suzanne Gill, Tiffany Kan, Jackie Campbell, Alex Kiss, Janine B McCready, Pavani Das, Brian Minnema, Jeff E Powis, Sandra A N Walker, Heather Ferguson, Benny Wong, Elizabeth Weber
Background: Beta-lactam allergy skin testing (BLAST) is recommended by antimicrobial stewardship program (ASP) guidelines, yet few studies have systematically evaluated its impact when delivered at point-of-care. Methods.: We conducted a pragmatic multicenter prospective evaluation of the use of point-of-care BLAST by ASPs. In staggered 3-month intervals, ASP teams at three hospitals received training by allergists to offer BLAST for eligible patients with infectious diseases receiving non-preferred beta-lactam therapy due to severity of their allergy...
June 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28504314/next-step-in-antibiotic-stewardship-pharmacist-provided-penicillin-allergy-testing
#16
Z Gugkaeva, J S Crago, M Yasnogorodsky
WHAT IS KNOWN: Penicillin allergy limits therapeutic options for patients but often disappears over time, leaving patients erroneously labelled allergic and leading to the utilization of broad-spectrum and more expensive antibiotics. Penicillin allergy can be effectively assessed via skin testing. OBJECTIVE: To improve patient access to penicillin allergy testing by implementing a pharmacist-provided service in a hospital setting. COMMENT: Beta-lactams remain a mainstream therapy for many infections due to their effectiveness, low side effects and affordability...
August 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28483315/addressing-inpatient-beta-lactam-allergies-a-multihospital-implementation
#17
REVIEW
Kimberly G Blumenthal, Erica S Shenoy, Anna R Wolfson, David N Berkowitz, Victoria A Carballo, Diana S Balekian, Kathleen A Marquis, Ramy Elshaboury, Ronak G Gandhi, Praveen Meka, David W Kubiak, Jennifer Catella, Barbara B Lambl, Joyce T Hsu, Monique M Freeley, Alana Gruszecki, Paige G Wickner
Addressing inaccurate penicillin allergies is encouraged as part of antibiotic stewardship in the inpatient setting. However, implementing interventions targeted at the 10% to 15% of inpatients reporting a previous penicillin allergy can pose substantial logistic challenges. We implemented a computerized guideline for patients with reported beta-lactam allergy at 5 hospitals within a single health care system in the Boston area. In this article, we describe our implementation roadmap, including both successes achieved and challenges faced...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28382604/non-immediate-cutaneous-reactions-to-beta-lactams-approach-to-diagnosis
#18
REVIEW
Antonino Romano, Rocco Luigi Valluzzi, Cristiano Caruso, Michela Maggioletti, Francesco Gaeta
Non-immediate cutaneous reactions (i.e., occurring at least 1 h after the initial drug administration), particularly maculopapular exanthemas and urticarial eruptions, are common during beta-lactam treatments. A T cell-mediated pathogenic mechanism has been demonstrated in some cutaneous reactions, such as maculopapular exanthema, fixed drug eruption, acute generalized exanthematous pustulosis, and drug-induced hypersensitivity syndrome. In the diagnostic work-up, patch testing is useful, together with delayed-reading intradermal testing...
April 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28279979/penicillin-allergy-getting-the-label-right
#19
(no author information available yet)
Penicillin(i) allergy is a potentially serious adverse reaction that impacts on antibacterial treatment options. Although it is commonly reported and recorded in medical records, only a minority of patients with a label of penicillin allergy actually have the condition confirmed. The term 'allergy' may be incorrectly applied to adverse reactions that do not have an immunological basis and inappropriate labelling of penicillin allergy can lead to the unnecessary avoidance of penicillins and other beta-lactam antibacterials...
March 2017: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/28236547/screening-for-beta-lactam-allergy-in-joint-arthroplasty-patients-to-improve-surgical-prophylaxis-practice
#20
Deanna L McDanel, Antoine E Azar, Amy M Dowden, Samantha Murray-Bainer, Nicolas O Noiseux, Melissa Willenborg, Charles R Clark, John J Callaghan, Ambar Haleem
BACKGROUND: The reliability of patient-reported penicillin allergies has been disputed. A Drug Allergy Clinic (DAC) was established at our institution in combination with an electronic best practice alert (BPA) in the Orthopedic Clinic. Joint arthroplasty patients with a reported history of beta-lactam allergy (HOBA) were preoperatively referred via the BPA to the DAC. The purpose of this study was to determine the effectiveness of beta-lactam allergy screening in enabling the surgical team to optimize antimicrobial prophylaxis...
January 17, 2017: Journal of Arthroplasty
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