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beta-lactam allergy

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https://www.readbyqxmd.com/read/28575226/point-of-care-beta-lactam-allergy-skin-testing-by-antimicrobial-stewardship-programs-a-pragmatic-multicenter-prospective-evaluation
#1
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
#2
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...
May 14, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28483315/addressing-inpatient-beta-lactam-allergies-a-multihospital-implementation
#3
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
#4
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
#5
(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
#6
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
https://www.readbyqxmd.com/read/28139320/extended-use-of-perioperative-antibiotics-in-head-and-neck-microvascular-reconstruction
#7
Stefanie Saunders, Stephen Reese, Jimmy Lam, Jacqueline Wulu, Scharkuh Jalisi, Waleed Ezzat
PURPOSE: Many head and neck surgical procedures are considered clean-contaminated wounds and antibiotic prophylaxis is recommended. Despite prophylaxis, the incidence of surgical site infections remains significant - especially in the setting of free tissue transfer. The antibiotic course is often of a longer duration after free tissue transfer than the recommended 24hour post-operatively. Currently, there is no consensus on appropriate antibiotic regimen or duration at this time. This study investigates the outcomes of a 7-day perioperative antibiotic regimen after microvascular reconstruction of the head and neck at our institution...
March 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28112529/frequency-and-risk-factors-of-penicillin-and-amoxicillin-allergy-in-suspected-patients-with-drug-allergy
#8
Mohammad Reza Fazlollahi, Katayoon Bidad, Raheleh Shokouhi, Raheleh Dashti, Mohammad Nabavi, Masoud Movahedi, Mohammad Hasan Bemanian, Ali Reza Shafiei, Najmoddin Kalantari, Effat Sadat Farboud, Zahra Pourpak, Mostafa Moin
BACKGROUND: Unconfirmed beta-lactam allergy is a significant public health problem because of the limitations it imposes in drug selection. In this study, we aimed to evaluate patients referred for beta-lactam allergy to determine the frequency of confirmed beta-lactam allergy and identify some risk factors. METHODS: In a prospective cohort study, all referred patients to Immunology, Asthma and Allergy Research Institute in Tehran University of Medical Sciences (between 2007 - 2009) who suspected to have beta-lactam allergy were entered into this study based on having the inclusion criteria...
January 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/27956906/prevalence-of-beta-lactam-allergy-a-retrospective-chart-review-of-drug-allergy-assessment-in-a-predominantly-pediatric-population
#9
Elissa M Abrams, Andrew Wakeman, Tom V Gerstner, Richard J Warrington, Alexander G Singer
BACKGROUND: Research suggests that 90% of patients labeled beta-lactam allergic are able to tolerate penicillins following further assessment. This study aims to define and describe the frequency of true beta-lactam allergy following allergy patient evaluation in a predominantly pediatric population. METHODS: 306 primary care patients referred between January 2010 and June 2015 were assessed for a suspected beta-lactam allergy. Patient demographics, history and test results were extracted from electronic medical records...
2016: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/27888034/a-proactive-approach-to-penicillin-allergy-testing-in-hospitalized-patients
#10
Justin R Chen, Scott A Tarver, Kristin S Alvarez, Trang Tran, David A Khan
BACKGROUND: Penicillin allergy testing is underutilized in inpatients despite its potential to immediately impact antibiotic treatment. Although most tested patients are able to tolerate penicillin, limited availability and awareness of this tool leads to the use of costly and harmful substitutes. OBJECTIVE: We established an inpatient service at a large academic hospital to identify and test patients with a history of penicillin allergy with the goals of removing inaccurate diagnoses, reducing the use of beta-lactam alternatives, and educating patients and clinicians about the procedure...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27888028/identifying-allergic-drug-reactions-through-placebo-controlled-graded-challenges
#11
Melissa Iammatteo, Denisa Ferastraoaru, Rebecca Koransky, Santiago Alvarez-Arango, Niharika Thota, Ayobami Akenroye, Elina Jerschow
BACKGROUND: Graded challenges are performed to exclude hypersensitivity reactions in patients with a low likelihood of drug allergy. Literature regarding optimal protocols with a defined number of steps and use of placebo is lacking. OBJECTIVE: To identify allergic drug reactions (ADRs) through a 3-step protocol composed of placebo followed by a 2-step graded drug challenge. METHODS: We performed a 5-year retrospective chart review of all patients with historical ADRs who underwent single-blind, placebo-controlled graded drug challenges between October 2010 and November 2015 at an outpatient drug allergy clinic...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27852424/hypersensitivity-to-beta-lactam-antibiotics-a-three-year-study
#12
I Mota, Â Gaspar, M Chambel, S Piedade, M Morais-Almeida
BACKGROUND: Beta-lactams antibiotics (BL) are the most frequent elicitors of allergic drug reactions. The aim of our study was to characterize the patients referred with suspected hypersensitivity (HS) to BL. METHODS: Over a three-year period (2011-2013), a total of 234 adult and paediatric patients (pts) with suspected HS to BL were investigated according to the European Network for Drug Allergy guidelines. RESULTS: HS to BL was confirmed in 43 pts (18%), without differences between adult and paediatric pts; anaphylaxis was reported by 20 pts...
November 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27745795/impact-of-a-pharmacist-driven-beta-lactam-allergy-interview-on-inpatient-antimicrobial-therapy-a-pilot-project
#13
Nicholas S Sigona, Jeffrey M Steele, Christopher D Miller
OBJECTIVES: To determine the impact of a pharmacist-driven beta-lactam allergy interview on antimicrobial therapy. SETTING: Tertiary care academic medical center. PRACTICE SETTING: Clarification of beta-lactam allergy may expand treatment options for patients and potentially improve outcomes, reduce toxicity, and reduce costs. PRACTICE INNOVATION: At our institution, a pilot service using a pharmacy resident and infectious diseases clinical pharmacist was implemented to clarify beta-lactam allergy information and, where appropriate, recommend a change to the patient's antibiotic therapy...
October 8, 2016: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/27569064/optimal-step-doses-for-drug-provocation-tests-to-prove-beta-lactam-hypersensitivity
#14
A-M Chiriac, T Rerkpattanapipat, P-J Bousquet, N Molinari, P Demoly
BACKGROUND: Drug provocation tests (DPT) are commonly performed as part of β-lactam (BL) allergy workup, in case of negative skin tests (ST) and in the absence of contraindications. The recommendations of learned societies have created a frame for DPT performance, but protocols vary widely between centres, generating various hypothesis-driven protocols (i.e. empirical dosing, driven by both safety concerns and practical aspects). METHODS: The primary objective of this retrospective analysis was to detect eliciting dose thresholds (reactive doses) during BL DPT, using the survival analysis method, in order to suggest optimal step doses...
August 29, 2016: Allergy
https://www.readbyqxmd.com/read/27560911/-evaluation-and-characterization-of-125-patients-with-a-history-of-reaction-to-beta-lactams
#15
Kaddy Juliana Beltrán-Sierra, Jorge Sánchez, Ricardo Cardona
BACKGROUND: Reactions to beta-lactams are frequent and it is difficult to establish the relationship between the drug and symptoms. OBJECTIVE: To describe the clinical characteristics and explore the immunological mechanisms of patients with suspected adverse reaction to beta-lactams. METHODS: Retrospective study of patients with a history of beta-lactam reaction and tests for reactions to drugs. RESULTS: Out of 125 patients, 71 were women (56...
July 2016: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
https://www.readbyqxmd.com/read/27543745/performance-in-real-life-of-the-european-network-on-drug-allergy-algorithm-in-immediate-reactions-to-beta-lactam-antibiotics
#16
E Moreno, E Laffond, F Muñoz-Bellido, M T Gracia, E Macías, A Moreno, I Dávila
European Network on Drug Allergy (ENDA) has proposed an algorithm for diagnosing immediate beta-lactam (BL) allergy. We evaluated its performance in real life. During 1994-2014, 1779 patients with suspected immediate reactions to BL were evaluated following ENDA's short diagnostic algorithm. Five hundred and nine patients (28.6%) were diagnosed of BL hypersensitivity. Of them, 457 (25.7%) were at first evaluation [403 by skin tests (ST), 12 by positive IgE and 42 by controlled provocation tests (CPT)]. At second evaluation (SE), 52 additional patients (10...
December 2016: Allergy
https://www.readbyqxmd.com/read/27530619/the-revolving-door-antibiotic-allergy-labelling-in-a-tertiary-care-centre
#17
B Knezevic, D Sprigg, J Seet, M Trevenen, J Trubiano, W Smith, Y Jeelall, S Vale, R Loh, A McLean-Tooke, M Lucas
BACKGROUND: Patients frequently report antibiotic allergies; however, only 10% of labelled patients have a true allergy. AIM: We investigated the documentation of antibiotic 'allergy' labels (AAL) and the effect of labelling on clinical outcomes, in a West Australian adult tertiary hospital. METHODS: Retrospective cross-sectional analysis of patients captured in the 2013 and 2014 National Antimicrobial Prescribing Surveys was carried out. Data were collected on documented antibiotic adverse drug reactions, antibiotic cost, prescribing appropriateness, prevalence of multi-drug resistant organisms, length of stay, intensive care admission and readmissions...
November 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27459839/-basopil-activation-test-bat-as-a-novel-method-for-monitoring-occupational-exposure-to-beta-lactams-and-intermediates-of-production
#18
COMPARATIVE STUDY
Paolo Marraccini, Patrizia Pignatti, Cosimo Cafforio, Marco Emilio Prini
BACKGROUND: Cutaneous tests and specific IgE are used in the diagnosis of allergy due to beta-lactans, although drug administration at therapeutic dosage is considered gold standard in drug allergy. OBJECTIVES: The diagnostic approach in symptomatic workers is more critical when they are exposed because of work, unlike reactions to drug in case of therapy. There is not a general consensus about markers in workers occupationally exposed to drugs. Indeed, basophil activation test (BAT) is a new and promising laboratory tool, particularly useful to test intermediate molecules involved in the production...
April 2016: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
https://www.readbyqxmd.com/read/27427544/-spanish-society-of-pediatric-infectious-diseases-spanish-society-of-paediatric-clinical-immunology-and-allergy-spanish-association-of-paediatric-primary-care-and-the-spanish-society-of-extra-hospital-paediatrics-and-primary-health-care-consensus-document-on
#19
Fernando Baquero-Artigao, Antonio Michavila, Ángeles Suárez-Rodriguez, Anselmo Hernandez, Leticia Martínez-Campos, Cristina Calvo
The suspected allergy to beta-lactam antibiotics, especially penicillin and amoxicillin, is the most frequent reason for consultation in Child Allergy Units. In this consensus document, the clinical and diagnostic criteria of allergic reactions are described, as well as alternative antibiotic treatment for the most common infections diagnosed in paediatrics for patients with known or suspected allergy.
February 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27421128/-community-acquired-pneumonia-treatment-options-according-to-the-international-recommendations
#20
Katarzyna Lewandowska, Jan Kuś
Pneumonia remains one of the main reasons of heath care system utilization. Quick diagnosis and prompt treatment initiation determine favorable outcome. Empirical antibiotic treatment allows to achieve treatment success in most patients. Treatment recommendations are based on big epidemiological trials. Nevertheless, it is sometimes necessary to know the definite etiologic factor of pneumonia. In these cases microbiological diagnostics is useful, i.e. sputum microscopy and culture, blood culture, bronchial lavage culture, bacterial antigen tests in urine, molecular tests...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
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