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Beta lactam allergy

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https://www.readbyqxmd.com/read/28814358/frequency-of-selective-immediate-responders-to-aminopenicillins-and-cephalosporins-in-turkish-children
#1
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
#2
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...
July 25, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28752367/update-on-quinolone-allergy
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
(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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
April 2017: Allergy
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