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penicillin allergy aztreonam

Allison Ramsey, Mary L Staicu
BACKGROUND: Penicillin allergy is the most commonly reported antibiotic allergy. Avoidance of β-lactam antibiotics in hospitalized patients leads to the use of second-line therapies. OBJECTIVE: The utility of a penicillin allergy history algorithm (PAHA) and subsequent penicillin skin testing (PST) in transitioning hospitalized patients from second- to first-line antibiotic therapy is described. METHODS: Through an electronic medical record report, pharmacists identified adult inpatients with penicillin allergy receiving moxifloxacin, intravenous vancomycin, aztreonam, daptomycin, or linezolid, in which a β-lactam antibiotic was preferred...
December 11, 2017: Journal of Allergy and Clinical Immunology in Practice
Bruce M Jones, Christopher M Bland
PURPOSE: An initiative to determine the effects of penicillin skin testing (PST) from an antimicrobial stewardship perspective is described. SUMMARY: Penicillin allergy is one of the most frequently reported allergies; however, only about 10% of self-reports of penicillin allergy are accurate. Incorrect penicillin allergies are therefore a significant barrier to antimicrobial stewardship, with important clinical and economic implications, including increased antimicrobial resistance, an increased overall cost of care, increased length of stay, and, ultimately, increased mortality...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
Benjamin Davido, Aurelien Dinh, Olivia Senard, Ruxandra Calin, Sabrina Makhloufi, Jerome Salomon
Objectives: To determine whether aztreonam is still an effective drug for the treatment of gonorrhoea. Methods: Observational study of patients with gonorrhoea diagnosed by urine multiplex PCR, with a past medical history of allergy to β-lactams or relapse after treatment with a third-generation cephalosporin. Patients received a single 1 g dose of aztreonam in accordance with the manufacturer's instructions. Results: Five patients (four males, one female) were enrolled, comprising two who were allergic to β-lactams and three previously treated with cephalosporins who relapsed...
May 1, 2017: Journal of Antimicrobial Chemotherapy
Esther A King, Sridevi Challa, Patrick Curtin, Leonard Bielory
BACKGROUND: A history of a penicillin allergy generally leads to the use of broad-spectrum antibiotics that may increase complications and cost. OBJECTIVE: To determine the cost-effectiveness of performing penicillin skin testing (PST). METHODS: A retrospective analysis was conducted on adult inpatients with a β-lactam allergy who underwent PST and oral challenge performed by an allergist. The primary outcome was overall antibiotic cost savings for patients switched to a β-lactam antibiotic (BLA)...
July 2016: Annals of Allergy, Asthma & Immunology
Antonino Romano, Francesco Gaeta, Maria Francisca Arribas Poves, Rocco Luigi Valluzzi
Penicillins and cephalosporins are the major classes of beta-lactam (BL) antibiotics in use today and one of the most frequent causes of hypersensitivity reactions to drugs. Monobactams, carbapenems, oxacephems, and beta-lactamase inhibitors constitute the four minor classes of BLs. This review takes into account mainly the prospective studies which evaluated cross-reactivity among BLs in subjects with a well-demonstrated hypersensitivity to a certain class of BLs by performing allergy tests with alternative BLs and, in case of negative results, administering them...
March 2016: Current Allergy and Asthma Reports
Mary L Staicu, Mary Lourdes Brundige, Allison Ramsey, Jack Brown, Alexandra Yamshchikov, Derick R Peterson, Andrea Baran, Maryrose Laguio-Vila
PURPOSE: The implementation of a penicillin allergy screening tool to optimize the use of aztreonam is described. METHODS: This study was conducted at a 528-bed tertiary referral community teaching facility and compared the use of aztreonam in patients before and after the implementation of a multipronged intervention consisting of a penicillin allergy screening tool (PAST), education, order set decision support, and prospective review of aztreonam orders by the antimicrobial stewardship team and clinical pharmacists...
March 1, 2016: American Journal of Health-system Pharmacy: AJHP
Sara M Swearingen, Cyle White, Sara Weidert, Melisande Hinds, John P Narro, Anthony J Guarascio
BACKGROUND: Local antimicrobial susceptibility patterns should be considered for antimicrobial therapy decisions. Antibiogram data can guide beta-lactam antibiotic use in the presence of a penicillin allergy, particularly when allergic cross-reactivity among antibiotic agents is unlikely. OBJECTIVE: To evaluate the effect of a multidimensional antimicrobial stewardship intervention to improve antibiogram-driven antibiotic selection for patients with a reported penicillin allergy receiving aztreonam...
April 2016: International Journal of Clinical Pharmacy
Kimberly G Blumenthal, Erica S Shenoy, Christy A Varughese, Shelley Hurwitz, David C Hooper, Aleena Banerji
BACKGROUND: Self-reported penicillin allergy infrequently reflects an inability to tolerate penicillins. Inpatients reporting penicillin allergy receive alternative antibiotics that might be broader spectrum, more toxic, or less effective. OBJECTIVE: To develop and assess a clinical guideline for the general inpatient provider that directs taking a history and prescribing antibiotics for patients with penicillin or cephalosporin allergy. METHODS: A guideline was implemented to assist providers with assessing allergy history and prescribing antibiotics for patients with reported penicillin or cephalosporin allergy...
October 2015: Annals of Allergy, Asthma & Immunology
Justin M Jones, Lisa M Richter, Augusto Alonto, David D Leedahl
PURPOSE: The case of a patient with multiple medication hypersensitivity reactions and a methicillin-resistant Staphylococcus aureus (MRSA) infection who underwent desensitization to ceftaroline is reported. SUMMARY: A 32-year-old Caucasian woman with asthma, gastroesophageal reflux disease, heart murmur, and major depression was admitted for MRSA cellulitis with a subcutaneous abscess along the left sternomanubrial joint and clavicular osteomyelitis secondary to port placement after gastric bypass surgery...
February 1, 2015: American Journal of Health-system Pharmacy: AJHP
Lauren Rodriguez, Hee Soo Jung, James A Goulet, Ashley Cicalo, David A Machado-Aranda, Lena M Napolitano
BACKGROUND: Evidence-based guidelines for prophylactic antibiotic use in open fractures recommend short-course, narrow-spectrum antibiotics for Gustilo Grade I or II open fractures and broader gram-negative coverage for Grade III open fractures. No studies to date have assessed the impact of these guidelines on infection rates in open fractures. Infection rates before and after the new protocol implementation were examined. METHODS: A new protocol was implemented including antibiotic prophylaxis based on grade of open fracture: Grade I/II fractures, cefazolin (clindamycin if allergy); Grade III fractures, ceftriaxone (clindamycin and aztreonam if allergy) for 48 hours...
September 2014: Journal of Trauma and Acute Care Surgery
Adrienne T Terico, Jason C Gallagher
Penicillin is the most frequently reported cause of drug allergy, and cross-reactivity of penicillins with other beta-lactam antibiotics is an area of debate. This review evaluates the available data on immunoglobulin E-mediated penicillin hypersensitivity and cross-reactivity with cephalosporin, carbapenem, and monobactam antibiotics. A MEDLINE search was conducted from 1950 to October 2013, and selected references from review articles were also evaluated. There is a wide variety in reported incidences of cross-reactivity between penicillins and cephalosporins or carbapenems, with early retrospective studies suggesting up to 41...
December 2014: Journal of Pharmacy Practice
B J McCullough, L E Wiggins, A Richards, K Klinker, J W Hiemenz, J R Wingard
BACKGROUND: Beta-lactam antibiotics are the mainstay of empiric therapy for febrile neutropenia. Aztreonam may benefit certain patients because of a lack of cross-hypersensitivity to penicillins and cephalosporins. This is the first study, to our knowledge, to evaluate the efficacy of aztreonam as monotherapy for febrile neutropenia (FN). METHODS: Our study was a single-center retrospective chart review of patients ≥18 years of age receiving aztreonam for the treatment of FN...
February 2014: Transplant Infectious Disease: An Official Journal of the Transplantation Society
L Klimek, C Aderhold, A Sperl
BACKGROUND: In 2009, over 40 million prescriptions for antibiotic drugs were counted in outpatient medical care in Germany. This represents a turnover of more than 750 million euros. With over 80 million daily defined doses (DDD), amoxicillin was the most frequently prescribed antibiotic in Germany in 2008. Given the average of 5775 DDD per doctor, otolaryngologists prescribed more antibiotics than specialists in any other field of medicine in 2008; approximately 82% of these were β-lactams and tetracyclines...
May 2013: HNO
S Caimmi, D Caimmi, E Lombardi, G Crisafulli, F Franceschini, G Ricci, G L Marseglia
Antibiotics are commonly injected during the perioperative period and are responsible of 15 percent of the anaphylactic reactions. Anaphylaxis triggered by antibiotics primarily involves penicillin and cephalosporin. The management of patients with histories of allergic reactions to antibiotics is a common situation in clinical practice. The confirmation or invalidation of the allergic nature of the reported reaction is not based on in vitro tests, but on a rigorous allergological work-up based on detailed analysis of clinical history, skin tests and drug provocation test...
July 2011: International Journal of Immunopathology and Pharmacology
A Buonomo, E Nucera, T De Pasquale, V Pecora, C Lombardo, V Sabato, A Colagiovanni, A Rizzi, A Aruanno, L Pascolini, G Patriarca, D Schiavino
BACKGROUND: Cross-reactivity between aztreonam and β-lactams is poor, but tolerability of aztreonam has been assessed in a few groups of patients suffering from IgE-mediated allergy to β-lactams. The aim of this study was to assess the cross-reactivity of aztreonam with other β-lactams and its tolerability in patients with cell-mediated allergy to these drugs. METHODS: We studied 78 patients with cell-mediated allergy to β-lactams who underwent skin prick, immediate and delayed-reading intradermal tests as well as patch tests with penicilloyl-polylysine, minor determinant mixture, semi-synthetic penicillins, cephalosporins, aztreonam and imipenem...
2011: International Archives of Allergy and Immunology
Antonino Romano, Francesco Gaeta, Rocco Luigi Valluzzi, Cristiano Caruso, Gabriele Rumi, Philippe Jean Bousquet
BACKGROUND: There have been few studies regarding the cross-reactivity and tolerability of penicillins, aztreonam, and carbapenems in large samples of subjects with cephalosporin allergy. OBJECTIVE: We sought to evaluate the possibility of using penicillins, monobactams, and carbapenems in subjects with cephalosporin allergy who especially require them. METHODS: We conducted a prospective study of 98 consecutive subjects who had 106 immediate reactions (mostly anaphylactic shock) to cephalosporins and had positive skin test results for these drugs...
November 2010: Journal of Allergy and Clinical Immunology
Jane Frumin, Jason C Gallagher
OBJECTIVE: To evaluate the literature on the allergic cross-reactivity between penicillin, carbapenem, and monobactam antibiotics. DATA SOURCES: A MEDLINE search (1950-June 2008) of the English literature was performed using the search terms beta-lactam, penicillin, monobactam, carbapenem, allergy, and cross-reactivity. References of review articles were also screened for inclusion. STUDY SELECTION AND DATA EXTRACTION: All articles in English from the data source were identified...
February 2009: Annals of Pharmacotherapy
John P Knorr, Mersedeh Moshfeghi, Mary C Sokoloski
PURPOSE: A case of Q-T interval prolongation in a pediatric patient with no known risk factors for the development of a long Q-T syndrome is reported. SUMMARY: A 16-year-old boy arrived at a children's hospital reporting mucous diarrhea that had lasted two weeks, light-headedness with two blackouts on the day before his arrival to the hospital, and a 4.3-kg weight loss over the previous three weeks. He had a 3.5-year history of Crohn's disease and had been hospitalized for two months with a diagnosis of colitis with cryptitis...
March 15, 2008: American Journal of Health-system Pharmacy: AJHP
Judith A Burrows, Lisa M Nissen, Carl M J Kirkpatrick, Scott C Bell
BACKGROUND: Allergic reactions to one or more beta-lactam antibiotic can pose a management problem in patients with cystic fibrosis (CF), and may limit antibiotic choice. METHOD: The aim of this study was to assess the prevalence of allergy to anti-pseudomonal beta-lactam antibiotics in an adult CF centre and to assess variables, which may contribute to the development of allergic reactions. A questionnaire-based interview and a review of medical records were performed...
July 2007: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
J S Parmar, S Nasser
Allergic reactions to antibiotics are more common in cystic fibrosis (CF) than in the general population. This in part is due to the improving survival in adults with CF and the increased use of high dose intravenous antibiotics. While some are immediate anaphylaxis type (IgE mediated) reactions, the majority are late onset and may have non-specific features such as rash and fever. Piperacillin has consistently been found to have the highest rate of reported reactions (30-50%). There is a low risk of cross reactions between penicillins and other non-beta-lactam classes of antibiotics in penicillin skin prick positive patients...
June 2005: Thorax
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