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https://www.readbyqxmd.com/read/28179249/penicillin-skin-testing-as-an-antimicrobial-stewardship-initiative
#1
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
https://www.readbyqxmd.com/read/28174914/penicillin-allergy-testing-a-key-component-of-antibiotic-stewardship
#2
Eric Macy, David A Khan, Mariana C Castells, David M Lang
No abstract text is available yet for this article.
February 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28152605/feasibility-benefits-and-limitations-of-a-penicillin-allergy-skin-testing-service
#3
Prasanna P Narayanan, Meghan N Jeffres
OBJECTIVE: To critically examine the feasibility, benefits, and limitations of an inpatient penicillin skin testing service and how pharmacists can be utilized. DATA SOURCES: A PubMed search was performed from July 2016 through September 2016 using the following search terms: penicillin skin testing, penicillin allergy, β-lactam allergy. Additional references were identified from a review of literature citations. STUDY SELECTION AND DATA EXTRACTION: All English-language studies assessing the use of penicillin skin testing as well as management and clinical outcomes of patients with a β-lactam allergy were evaluated...
February 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28137938/repurposing-an-old-drug-aztreonam-as-a-new-treatment-strategy-for-gonorrhoea
#4
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...
January 30, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28112529/frequency-and-risk-factors-of-penicillin-and-amoxicillin-allergy-in-suspected-patients-with-drug-allergy
#5
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/28055069/clarifying-a-penicillin-allergy-a-teachable-moment
#6
Alon Vaisman, Janine McCready, Jeff Powis
No abstract text is available yet for this article.
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28035690/%C3%AE-lactam-therapy-for-methicillin-susceptible-staphylococcus-aureus-bacteremia-a-comparative-review-of-cefazolin-versus-antistaphylococcal-penicillins
#7
Julius Li, Kelly L Echevarria, Kristi A Traugott
Methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia is associated with high morbidity and mortality. Traditionally, antistaphylococcal penicillins (ASPs) have been considered the agents of choice for the treatment of MSSA bacteremia. Vancomycin has been demonstrated to have poorer outcomes in several studies and is only recommended for patients with severe penicillin allergies. Although cefazolin is considered as an alternative to the ASPs for patients with nonsevere penicillin allergies, cefazolin offers several pharmacologic advantages over ASPs, such as more convenient dosing regimens, and antimicrobial stewardship programs are increasingly using cefazolin as the preferential agent for MSSA infections as part of cost-saving initiatives...
December 30, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/28005295/antibiotics-in-endodontics-a-review
#8
REVIEW
J J Segura-Egea, K Gould, B Hakan Şen, P Jonasson, E Cotti, A Mazzoni, H Sunay, L Tjäderhane, P M H Dummer
The overuse of antibiotics and the emergence of antibiotic-resistant bacterial strains is a global concern. This concern is also of importance in terms of the oral microbiota and the use of antibiotics to deal with oral and dental infections. The aim of this paper is to review the current literature on the indications and use of antibiotics and to make recommendations for their prescription in endodontic patients. Odontogenic infections, including endodontic infections, are polymicrobial, and in most cases, the prescription of antibiotics is empirical...
December 22, 2016: International Endodontic Journal
https://www.readbyqxmd.com/read/28002709/shortened-antimicrobial-treatment-for-acute-otitis-media-in-young-children
#9
RANDOMIZED CONTROLLED TRIAL
Alejandro Hoberman, Jack L Paradise, Howard E Rockette, Diana H Kearney, Sonika Bhatnagar, Timothy R Shope, Judith M Martin, Marcia Kurs-Lasky, Susan J Copelli, D Kathleen Colborn, Stan L Block, John J Labella, Thomas G Lynch, Norman L Cohen, MaryAnn Haralam, Marcia A Pope, Jennifer P Nagg, Michael D Green, Nader Shaikh
Background Limiting the duration of antimicrobial treatment constitutes a potential strategy to reduce the risk of antimicrobial resistance among children with acute otitis media. Methods We assigned 520 children, 6 to 23 months of age, with acute otitis media to receive amoxicillin-clavulanate either for a standard duration of 10 days or for a reduced duration of 5 days followed by placebo for 5 days. We measured rates of clinical response (in a systematic fashion, on the basis of signs and symptomatic response), recurrence, and nasopharyngeal colonization, and we analyzed episode outcomes using a noninferiority approach...
22, 2016: New England Journal of 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
#10
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/27956203/syphilis-during-pregnancy-a-preventable-threat-to-maternal-fetal-health
#11
REVIEW
Martha W F Rac, Paula A Revell, Catherine S Eppes
Syphilis remains the most common congenital infection worldwide and has tremendous consequences for the mother and her developing fetus if left untreated. Recently, there has been an increase in the number of congenital syphilis cases in the United States. Thus, recognition and appropriate treatment of reproductive-age women must be a priority. Testing should be performed at initiation of prenatal care and twice during the third trimester in high-risk patients. There are 2 diagnostic algorithms available and physicians should be aware of which algorithm is utilized by their testing laboratory...
December 9, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27910104/long-term-reproducibility-of-positive-patch-test-reactions-in-patients-with-non-immediate-cutaneous-adverse-drug-reactions-to-antibiotics
#12
André Pinho, Ana Marta, Inês Coutinho, Margarida Gonçalo
BACKGROUND: As in contact allergy, T cell-mediated hypersensitivity in non-immediate (NI) cutaneous adverse drug reactions (CADRs) to antibiotics is considered to be lifelong, but, in this setting, patch tests have rarely been repeated after long time intervals. OBJECTIVE: To evaluate the long-term reproducibility of positive patch test reactions to antibiotics in patients with NI CADRs. METHODS: Fifty-six patients with NI CADRs to antibiotics who had relevant positive reactions during patch testing were invited to repeat patch tests with a similar antibiotic series 2-15 years thereafter...
December 2, 2016: Contact Dermatitis
https://www.readbyqxmd.com/read/27909820/genomic-analysis-reveals-the-presence-of-a-class-d-beta-lactamase-with-broad-substrate-specificity-in-animal-bite-associated-capnocytophaga-species
#13
S Zangenah, A F Andersson, V Özenci, P Bergman
Capnocytophga canimorsus and Capnocytophga cynodegmi can be transmitted from cats and dogs to humans, and can cause a wide range of infections including wound infections, sepsis, or endocarditis. We and others recently discovered two new Capnocytophaga species, C. canis and C. stomatis, mainly associated with wound infections. The first-line treatment of animal bite related infections is penicillin, and in case of allergy, doxycycline and trimethoprim/sulfamethoxazole. However, there is a lack of antibiotic susceptibility patterns for animal bite associated Capnocytophaga species...
December 1, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27888034/a-proactive-approach-to-penicillin-allergy-testing-in-hospitalized-patients
#14
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...
November 22, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27864093/skin-testing-and-drug-challenge-outcomes-in-antibiotic-allergic-patients-with-immediate-type-hypersensitivity
#15
Stephanie L Mawhirt, Luz S Fonacier, Rose Calixte, Mark Davis-Lorton, Marcella R Aquino
BACKGROUND: The evaluation of antibiotic immediate-type hypersensitivity is intricate because of nonstandardized skin testing and challenge method variability. OBJECTIVE: To determine the safety outcomes and risk factors for antibiotic challenge reactions in patients reporting a history of antibiotic immediate-type hypersensitivity. METHODS: A 5-year retrospective review of patients evaluated for immediate-type antibiotic allergy was conducted...
January 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27862587/are-non-allergic-drug-reactions-commonly-documented-as-medication-allergies-a-national-cohort-of-veterans-admissions-from-2000-to-2014
#16
Kevin W McConeghy, Aisling R Caffrey, Haley J Morrill, Amal N Trivedi, Kerry L LaPlante
PURPOSE: Adverse drug reactions (ADRs) including medication allergies are not well-described among large national cohorts. This study described the most common documented medication allergies and their reactions among a national cohort of Veterans Affairs (VA) inpatients. METHODS: We evaluated inpatient admissions in any VA Medical Center from 1 January 2000 to 31 December 2014. Each admission was linked with allergy history preceding or upon admission. Individual drugs were aggregated into drug class category including: penicillins, sulfonamides, angiotensin converting enzyme (ACE) inhibitors, opiates, HMG-CoA reductase inhibitors ("statins") and non-steroidal anti-inflammatory inhibitors (NSAID)...
November 13, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27852424/hypersensitivity-to-beta-lactam-antibiotics-a-three-year-study
#17
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/27779086/genetic-predictors-of-drug-hypersensitivity
#18
José A Cornejo-García, Abderrahim Oussalah, Miguel Blanca, Rosa-María Guéant-Rodríguez, Cristobalina Mayorga, Julie Waton, Annick Barbaud, Francesco Gaeta, Antonino Romano, Jean-Louis Guéant
Our knowledge of genetic predisposing factors of drug hypersensitivity reactions (DHRs) is still scarce. The analysis of the genetic basis of these reactions may contribute to dissect the underlying mechanisms. We will outline current knowledge of the genetic predictors of most common DHRs, including reactions to betalactam antibiotics (BLs), nonsteroidal anti-inflammatory drugs (NSAIDs) and biological agents. The predictors of DHRs to BLs are mostly linked to IgE-class switching, IgE pathway and atopy (IL4R, NOD2, LGALS3) in replicated candidate gene studies, and to antigen presentation (HLA-DRA) in the single replicated GWAS performed so far...
September 27, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27765460/allergy-profile-should-be-updated-after%C3%A2-uneventful-administration-of-a-penicillin-or-penicillin-related-antibiotic-to-a-patient-with-penicillin-allergy
#19
Wesley D Oliver, Emily L Heil, Kerri A Thom, Joseph P Martinez, Bryan D Hayes
No abstract text is available yet for this article.
October 17, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27752374/empyema-secondary-to-actinomyces-meyeri-treated-successfully-with-ceftriaxone-followed-by-doxycycline
#20
Etienne Paris, Tonio Piscopo, Karen Cassar
Actinomycosis is a relatively rare infection caused by Gram-positive bacteria. We present the case of a 54-year-old, previously healthy, male patient with a history of severe penicillin allergy who developed severe pneumonia and empyema caused by Actinomyces meyeri. Presenting symptoms included productive cough, right upper quadrant pain, and chills and rigors. He required drainage of the empyema via tube and prolonged antibiotic treatment with intravenous ceftriaxone for 2 weeks followed by oral doxycycline for 6 months...
2016: Case Reports in Infectious Diseases
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