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Carbapenem and penicillin cross reactivity

Mona Al-Ahmad, Tito Rodriguez-Bouza
BACKGROUND: There are no studies on cross-reactivity of betalactams among patients allergic to penicillin, or on the negative predictive value (NPV) of penicillin allergy evaluation from Arabian Gulf countries. OBJECTIVE: We aimed to assess the role and NPV of drug provocation test (DPT) for betalactam hypersensitivity reactions in patients referred for allergy evaluation in Kuwait. METHODS: Skin test (ST) was performed for all patients with a history of betalactam hypersensitivity, other than anaphylaxis...
March 2018: Asian Pacific Journal of Allergy and Immunology
Mary L Staicu, Dipekka Soni, Kelly M Conn, Allison Ramsey
BACKGROUND: The negative effect of the penicillin allergy label on antibiotic use and patient outcomes has brought to light the need for thorough penicillin allergy assessments and heightened practitioner education. OBJECTIVE: To evaluate practitioner knowledge of penicillin allergy and the clinical approach to the patients with penicillin allergy. METHODS: An electronic survey was distributed to attending physicians, residents, pharmacists, nurse practitioners, and physician assistants practicing adult inpatient medicine at 2 community-based teaching hospitals from February to April 2016...
July 2017: Annals of Allergy, Asthma & Immunology
J A Trubiano, L J Worth, K Urbancic, T M Brown, D L Paterson, M Lucas, E Phillips
BACKGROUND/AIM: Antibiotic allergies are frequently reported and have significant impacts upon appropriate prescribing and clinical outcomes. We surveyed infectious diseases physicians, allergists, clinical immunologists and hospital pharmacists to evaluate antibiotic allergy knowledge and service delivery in Australia and New Zealand. METHODS: An online multi-choice questionnaire was developed and endorsed by representatives of the Australasian Society of Clinical Immunology and Allergy (ASCIA) and the Australasian Society of Infectious Diseases (ASID)...
November 2016: Internal Medicine Journal
A Buonomo, L Pascolini, A Rizzi, A Aruanno, V Pecora, A G Ricci, S Mezzacappa, A Di Rienzo, M Centrone, E Nucera, D Schiavino
BACKGROUND AND OBJECTIVE: Administration of carbapenems to β-lactam-allergic patients has always been considered potentially harmful because of a 47.4% rate of cross-reactivity to imipenem reported in a single study. Nevertheless, recent studies have shown that the rate of cross-reactivity of imipenem and meropenem with penicillins is lower than 1%. The aim of this study was to evaluate the possibility of using ertapenem in patients with an established IgE-mediated β-lactam allergy...
2016: Journal of Investigational Allergology & Clinical Immunology
Christina Caplinger, Garret Smith, Richard Remington, Karl Madaras-Kelly
Allergies to β-lactam antibiotics are commonly documented in hospitalized patients; however, true allergy is uncommon. Cross-reactivity rates for advanced generation cephalosporins and carbapenems are low; particularly for patients without a history of symptoms consistent with type 1 hypersensitivity. We observed that providers preferentially prescribed antipseudomonal carbapenems (APC) over advanced generation cephalosporins for patients with β-lactam allergy history, including those with low risk for antimicrobial-resistant infections...
January 15, 2016: Antibiotics
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
E Dias de Castro, A Leblanc, A Sarmento, J R Cernadas
Recent studies have demonstrated a low cross-reactivity between β-lactam antibiotics and carbapenems in IgE-mediated reactions. There are no studies on cross-reactivity of meropenem in patients with non-immediate hypersensitivity to cephalosporins. We describe a case of a 13-year-old male, admitted in Neurosurgery with a severe extradural empyema complicating frontal sinusitis, submitted to an emergent bifrontal craniotomy. A generalized maculopapular exanthema, fever and malaise, appeared by the 7th day of meningeal doses of ceftriaxone, clindamycin and vancomycin...
November 2015: European Annals of Allergy and Clinical Immunology
Thomas Tängden, Mia Furebring, Elisabeth Löwdin, Sonja Werner
Severe IgE-mediated allergic reactions to penicillins are rare but might be fatal. Because some studies demonstrated a high risk of cross-sensitivity to cephalosporins and carbapenems it has been recommended to avoid these antibiotics in patients with suspected hypersensitivity to penicillins. However, recent studies and analyses conclude that the risk of cross-reactivity was overestimated in the earlier studies and that it is in fact very low for parenteral cephalosporins and perhaps even negligible for carbapenems...
February 3, 2015: Läkartidningen
Francesco Gaeta, Rocco Luigi Valluzzi, Cristiana Alonzi, Michela Maggioletti, Cristiano Caruso, Antonino Romano
BACKGROUND: Studies performed on samples larger than 100 subjects with a documented IgE-mediated hypersensitivity to penicillins have demonstrated a cross-reactivity rate of approximately 1% between penicillins and both imipenem and meropenem, whereas a single study found a cross-reactivity rate of 6.2% with aztreonam in 16 such subjects. OBJECTIVE: To assess the cross-reactivity and tolerability of aztreonam and 3 carbapenems (imipenem-cilastatin, meropenem, and ertapenem) in patients with documented IgE-mediated hypersensitivity to penicillins...
April 2015: Journal of Allergy and Clinical Immunology
Eric Macy
Penicillin is the most common beta-lactam antibiotic allergy and the most common drug class allergy, reported in about 8% of individuals using health care in the USA. Only about 1% of individuals using health care in the USA have a cephalosporin allergy noted in their medical record, and other specific non-penicillin, non-cephalosporin beta-lactam allergies are even rarer. Most reported penicillin allergy is not associated with clinically significant IgE-mediated reactions after penicillin rechallenge. Un-verified penicillin allergy is a significant and growing public health problem...
November 2014: Current Allergy and Asthma Reports
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
Brittany Kula, Gordana Djordjevic, Joan L Robinson
BACKGROUND: Cross-reactivity between penicillins or cephalosporins and carbapenems is anticipated as all have a beta lactam ring. However, the true incidence of immunoglobulin (Ig)E-mediated cross-reactivity is not known. METHODS: A systematic review was conducted to collect and combine all published data on children and adults reported to have a clinical history of IgE-mediated hypersensitivity to a penicillin and/or cephalosporin who were subsequently given a carbapenem...
October 15, 2014: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
A Romano, F Gaeta, R L Valluzzi, C Alonzi, M Maggioletti, A Zaffiro, C Caruso, D Quaratino
Studies performed on subjects with IgE-mediated hypersensitivity to penicillins have demonstrated a 1% rate of cross-reactivity between penicillins and both imipenem and meropenem, while a single study found a 5.5% rate of cross-reactivity with imipenem/cilastatin in subjects with T-cell-mediated hypersensitivity to β-lactams, mostly penicillins. We studied 204 consecutive subjects with a well-demonstrated T-cell-mediated hypersensitivity to assess the cross-reactivity with carbapenems and the tolerability of such alternative β-lactams...
December 2013: Allergy
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
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
D Schiavino, E Nucera, C Lombardo, M Decinti, L Pascolini, G Altomonte, A Buonomo, G Patriarca
BACKGROUND: Administration of imipenem-cilastatin to patients with IgE-mediated hypersensitivity to beta-lactams has always been considered potentially harmful. Recent studies have demonstrated the tolerability of carbapenems (imipenem-cilastatin and meropenem) in patients with IgE-mediated hypersensitivity to beta-lactams; there are no studies on this topic regarding patients with cell-mediated allergy to beta-lactams. The aim of this study is to assess cross-reactivity and tolerability of imipenem in patients with cell-mediated allergy to beta-lactams...
November 2009: Allergy
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
M Atanasković-Marković, F Gaeta, B Medjo, M Viola, B Nestorović, A Romano
BACKGROUND: Administration of meropenem to penicillin-allergic patients who might benefit from this treatment is usually avoided because of a 47.4% rate of cross-reactivity to imipenem, the prototype of the carbapenem class of beta-lactam antibiotics, demonstrated in a single study on the basis of positive responses to skin tests with imipenem reagents. However, recent studies of ours have demonstrated a very low rate of cross-reactivity between penicillins and both meropenem and imipenem in adults...
February 2008: Allergy
William A Prescott, Kristen A Kusmierski
The risk of carbapenem hypersensitivity in patients with self-reported or documented penicillin allergy needs to be determined so that practitioners can make better-informed decisions regarding antibiotic therapy for this patient population. The risk of cross-reactivity between penicillin and carbapenem antibiotics initially was reported to approach 50%. Recent retrospective studies have suggested that the clinical risk of cross-hypersensitivity between these two drug classes is 9.2-11%, which is significantly lower than initially reported...
January 2007: Pharmacotherapy
C Antúnez, E Martín, J A Cornejo-García, N Blanca-Lopez, R R-Pena, C Mayorga, M J Torres, M Blanca
Immediate hypersensitivity reactions to betalactams are IgE mediated and constitute the most frequent allergic reactions mediated by specific immunological mechanisms. IgE responses to benzyl penicillin (BP), the first antibiotic producing the benzyl penicilloyl structure (BPO), are characterized by a quick release of inflammatory mediators, resulting in anaphylactic shock, urticaria and angioedema. With the progressive appearance of other structures, comprising cephalosporins, carbapenems, monobactams and clavulanic acid, IgE selective responses and cross-reactivity reactions were observed...
2006: Current Pharmaceutical Design
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