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beta-lactam allergy

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https://www.readbyqxmd.com/read/29669670/utilization-and-timeliness-of-an-inpatient-penicillin-allergy-evaluation
#1
Keith A Sacco, Razvan Chirila, Claudia Libertin, Brett Hiroto, Arveen Bhasin, Margaret M Johnson, Thanai Pongdee, M Caroline Burton
BACKGROUND: A history of penicillin allergy is associated with an increased risk of nosocomial infections because patients are exposed to non-beta lactam antibiotics. Ruling out inaccurate penicillin allergy during hospitalization decreases prescription of beta lactam antibiotics. However, the utilization of penicillin allergy testing and timeliness in relation to initiation of antibiotics is not known. OBJECTIVE: Our aim was to describe the proportion and characteristics of patients who underwent inpatient penicillin allergy testing in a hospital without a guideline or infrastructure for inpatient penicillin allergy testing...
May 1, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29665345/evaluation-of-ifn-%C3%AE-enzyme-linked-immunospot-assay-elispot-as-a-first-line-test-in-the-diagnosis-of-non-immediate-hypersensitivity-to-amoxicillin-and-penicillin
#2
Lenka Sedláčková, Miroslav Průcha, Ingrid Poláková, Blanka Míková
The current diagnostic algorithm for beta-lactam allergy is based on skin and provocation tests, both of which carry a certain risk of inducing hypersensitivity reactions. Thus, non-invasive in vitro tests reliable enough to replace skin and provocation tests at least in a portion of patients are desirable. We aimed to verify the utility of IFN-γ ELISPOT as a first-line test in patients with suspected non-immediate hypersensitivity reaction to amoxicillin (AMX) and penicillin (PNC). The prospective observational study included 24 patients with recent, suspected non-immediate hypersensitivity reaction to AMX or PNC and 6 recently-exposed healthy subjects...
2018: Prague Medical Report
https://www.readbyqxmd.com/read/29594180/influence-of-reported-penicillin-allergy-on-mortality-in-mssa-bacteremia
#3
Nicholas A Turner, Rebekah Moehring, Christina Sarubbi, Rebekah H Wrenn, Richard H Drew, Coleen K Cunningham, Vance G Fowler, Deverick J Anderson
Background: Penicillin allergy frequently impacts antibiotic choice. As beta-lactams are superior to vancomycin in treating methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia, we examined the effect of reported penicillin allergy on clinical outcomes in patients with MSSA bacteremia. Methods: In this retrospective cohort study of adults with MSSA bacteremia admitted to a large tertiary care hospital, outcomes were examined according to reported penicillin allergy...
March 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29588957/dress-syndrome-a-case-of-cross-reactivity-with-lacosamide
#4
Man Kei Fong, Bun Sheng
A 42-year-old patient with epilepsy was admitted to the hospital for fever and generalized skin rash. He has known allergy to phenytoin. Valproate was started in 2012, but failed to control his seizure despite gradual increase in dosage. Phenobarbitone was added 16 days before admission and was stopped on admission. He was treated with beta-lactam antibiotics. The rash subsided gradually after the cessation of phenobarbitone. Lacosamide was subsequently added for seizure control. Unfortunately, he developed drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome soon after introduction of lacosamide that required the use of systemic steroid for acute hepatitis...
June 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29551402/systematic-review-of-professional-liability-when-prescribing-beta-lactams-for-patients-with-a-known-penicillin-allergy
#5
REVIEW
Meghan N Jeffres, Elizabeth A Hall-Lipsy, S Travis King, John D Cleary
OBJECTIVE: To describe medical negligence and malpractice cases in which a patient with a known penicillin allergy received a beta-lactam and experienced an adverse reaction related to the beta-lactam. DATA SOURCES: Lexis-Nexus, Westlaw, and Google Scholar were searched. STUDY SELECTIONS: Medical negligence and malpractice cases were eligible for inclusion if they met the following criteria: the plaintiff had a known penicillin allergy, received a beta-lactam, and experienced an adverse event...
March 15, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29466923/impact-of-a-standardized-beta-lactam-allergy-questionnaire-on-aztreonam-use
#6
Kacie E Clark, Mary E Briand, Om Kapoor, Ameen Pirasteh
METHODS: This quasi-experimental study compared the aztreonam utilization in patients with self-reported beta-lactam allergies admitted to an inpatient service between two study periods (pre- and post-implementation). Post-implementation followed the initiation of a standardized beta-lactam allergy questionnaire, a student pharmacist-driven performance improvement project for beta-lactam allergy documentation. Interviews clarified the allergy, reaction history, and any previous tolerance of beta-lactams...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29383926/piperacillin-tazobactam-anaphylaxis-a-rare-cause-of-occupational-disease
#7
J Gaspar-Marques, E Finelli, P C Martins, S Prates, P Leiria-Pinto
Piperacillin is a beta-lactam antibiotic of penicillin family. Some penicillins were report-ed as occupational diseases cause, but piperacillin anaphylaxis with occupational sensi-tization is rare. We describe the case of a female nurse with recurrent anaphylaxis in last few months without apparent cause, only in work environment. Latex allergy was excluded after negative latex glove provocation. Later during diagnostic workup, the patient reported a similar reaction minutes after piperacillin preparation. She denied any previous antibiotic therapeutic exposure...
March 2018: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29346543/the-impact-of-reported-beta-lactam-allergy-in-hospitalized-patients-with-hematologic-malignancies-requiring-antibiotics
#8
Kuan-Hsiang Gary Huang, Valerie Cluzet, Keith Hamilton, Olajumoke Fadugba
Background: Patients hospitalized with hematologic malignancy are particularly vulnerable to infection. The impact of reported beta-lactam (BL) allergy in this population remains unknown. Objective: To define the impact of reported BL-only allergy (BLOA) label on clinical outcomes compared to those with no BL allergy (NBLA) in hematologic malignancy inpatients requiring systemic antibiotics. Methods: Retrospective cohort study of adult inpatients with hematologic malignancy admitted at two tertiary care hospitals 2010-2015...
January 16, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29341526/-the-internal-medicine-articles-that-struck-us-the-most-in-2017
#9
Vanessa Kraege, Evrim Jaccard, Alain Kenfak, Elisabeth Stamm, Fanny Blondet, Grégoire Humair, Plamena Tasheva, Oriane Aebischer, Sabine Giroud, Jonathan Tschopp, Claudio Sartori
2017 has continued to bring important progress in all areas of internal medicine, impacting our daily practice. From bedside screening for beta-lactam allergies, to statins as primary prevention in the elderly, SGLT2 inhibitors in heart failure, azithromycin in severe asthmatics and tofacitinib in ulcero-haemorrhagic recto-colitis, internal medicine journals are full of novelties. Every year, the chief residents of the CHUV internal medicine ward meet up to share their readings: here is their selection of eleven articles, chosen, summarized and commented for you...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29341525/-general-internal-medicine%C3%A2-2017-scientific-breakthroughs-in-ambulatory-care
#10
Alexandre Gouveia, Lionel De Alencastro, Yvonne Fierz, Lionel Koehli, Alexandre Béguelin, Olivier Pasche, Kevin Selby, Patrick Bodenmann
Bariatric surgery improves glycemic control in obese patients with diabetes type 2. Dual antiplatelet therapy can be maintained beyond 12 months after a myocardial infarction. Levothyroxine is not beneficial among patients ≥ 65 years that have subclinical hypothyroidism. Prophylactic anticoagulation in lower limb immobilisation should be reserved only for patients with a high risk of thromboembolism. A diagnosis of asthma should be initially confirmed by a spirometry if clinically suspected. A proton pump inhibitor is indicated for patients ≥ 65 years that are treated with aspirin...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29249136/pattern-of-inpatient-referrals-to-a-drug-allergy-unit-in-kuwait
#11
M Al-Ahmad, T Rodriguez Bouza
Introduction. There is no information regarding the pattern of inpatient referrals to drug allergy units in Kuwait. Objectives. The main goal of this study is to clarify the pattern of inpatient referrals to a drug allergy unit in terms of incidence, drugs implicated and allergy evaluation outcomes in comparison with studies in other countries. Patients and Methods. A retrospective chart review of inpatient drug allergy consultations at Al-Rashed Allergy Center over a 3-year period was performed. Results. A total of 51 patients were referred for drug allergy consultations, with an estimated incidence of reported drug allergy among inpatients of 0...
November 2017: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29175371/natural-history-of-benign-nonimmediate-allergy-to-beta-lactams-in-children-a-prospective-study-in-retreated-patients-after-a-positive-and-a-negative-provocation-test
#12
Aude Tonson la Tour, Marine Michelet, Philippe A Eigenmann, Jean-Christoph Caubet
BACKGROUND: The drug provocation test (DPT) is considered as the gold standard to diagnose drug allergy and is particularly important in the diagnosis of nonimmediate beta-lactam (BL) allergy in children. The natural history of BL allergy remains unknown. OBJECTIVE: Our main aim was to evaluate the natural history of nonimmediate BL hypersensitivity and the long-term tolerance acquisition, and our secondary objective was to determine the negative predictive value (NPV) of the DPT following a 2-day protocol...
November 23, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29162022/confronting-the-challenge-of-beta-lactam-allergies-a-quasi-experimental-study-assessing-impact-of-pharmacy-led-interventions
#13
Steven C Krey, Jeff Waise, Lee P Skrupky
OBJECTIVE: To improve allergy history documentation and increase the use of beta-lactams when appropriate in patients with a reported beta-lactam allergy. METHODS: This pre-post study was conducted at a 167-bed tertiary care community hospital and evaluated multidisciplinary interventions on allergy documentation and antibiotic selection. Interventions included education, creation of local practice guidelines, and modified practices for pharmacists and pharmacy technicians...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29047169/non-immediate-reading-skin-tests-and-prolonged-challenges-in-non-immediate-hypersensitivity-to-beta-lactams-in-children
#14
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 (48-72 hours) 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 hypersensitivity to BLs is yet to be determined. OBJECTIVES: To establish the diagnostic values of late-reading ST and hyper-late-reading ST and of prolonged DPT in children reporting non-immediate reactions to BLs...
February 2018: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28965636/management-of-children-with-hypersensitivity-to-antibiotics-and-monoclonal-antibodies
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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