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Penicillin allergy

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https://www.readbyqxmd.com/read/29242142/use-of-a-penicillin-allergy-screening-algorithm-and-penicillin-skin-testing-for-transitioning-hospitalized-patients-to-first-line-antibiotic-therapy
#1
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
https://www.readbyqxmd.com/read/29193647/the-incidence-characteristics-managements-and-outcomes-of-anaphylaxis-in-pregnancy-a-population-based-descriptive-study
#2
Stephen J McCall, Kathryn J Bunch, Peter Brocklehurst, Rhiannon D'Arcy, Kim Hinshaw, Jennifer J Kurinczuk, D Nuala Lucas, Benjamin Stenson, Derek Tuffnell, Marian Knight
OBJECTIVE: The aim of this study was to estimate the incidence of anaphylaxis in pregnancy and describe the management and outcomes in the UK. DESIGN: A population based descriptive study using the UK Obstetric Surveillance System(UKOSS). SETTING: All consultant-led maternity units in the UK. POPULATION: All pregnant women who had anaphylaxis between 1st October 2012 and 30th September 2015. Anaphylaxis was defined as a severe, life-threatening generalised or systemic hypersensitivity reaction...
November 29, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29181022/first-line-helicobacter-pylori-eradication-with-vonoprazan-clarithromycin-and-metronidazole-in-patients-allergic-to-penicillin
#3
Soichiro Sue, Nobumi Suzuki, Wataru Shibata, Tomohiko Sasaki, Hiroaki Yamada, Hiroaki Kaneko, Toshihide Tamura, Tomohiro Ishii, Masaaki Kondo, Shin Maeda
Aim: To assess the efficacy of 7-day first-line Helicobacter pylori eradication with vonoprazan (VPZ), clarithromycin (CAM), and metronidazole (MNZ) in patients with penicillin allergy. Methods: Patients with penicillin allergy, diagnosed with Helicobacter pylori infection and did not have history of Helicobacter pylori eradication, were eligible for the study. Twenty patients were prospectively treated with 20 mg VPZ twice daily, 200 or 400 mg CAM twice daily, and 250 mg MNZ twice daily for 7 days...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29177030/is-a-positive-intracutaneous-test-induced-by-penicillin-mediated-by-histamine-a-cutaneous-microdialysis-study-in-penicillin-allergic-patients
#4
Line K Tannert, Sidsel Falkencrone, Charlotte G Mortz, Carsten Bindslev-Jensen, Per Stahl Skov
Background: Diagnostic workup of penicillin allergy comprises skin testing with penicillins, and patients are deemed allergic if skin test is positive. However, the literature suggests that skin test-positive patients may be challenge-negative, indicating that the skin test may be falsely positive. Objective: To investigate real-time histamine release from a positive intracutaneous test induced by penicillin in patients with positive and negative challenges to penicillin...
2017: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29114827/persistence-of-penicillin-allergy-reply
#5
LETTER
Jason A Trubiano, N Franklin Adkinson, Elizabeth Jane Phillips
No abstract text is available yet for this article.
November 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29114824/persistence-of-penicillin-allergy
#6
LETTER
Vito Sabato, Margo Hagedorens, Didier Ebo
No abstract text is available yet for this article.
November 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29105102/impact-of-penicillin-allergy-on-empirical-carbapenem-use-in-gram-negative-bloodstream-infections-an-antimicrobial-stewardship-opportunity
#7
Majdi N Al-Hasan, Emily C Acker, Joseph E Kohn, P Brandon Bookstaver, Julie Ann Justo
OBJECTIVES: Retrospective matched cohort study evaluating association between penicillin allergy and empirical carbapenem use in gram-negative bloodstream infections (BSI) and utility of antimicrobial stewardship interventions in reducing carbapenem utilization. METHODS: Hospitalized adults with community-onset gram-negative BSI from January 1, 2010 to June 30, 2015 at two large community hospitals in Columbia, SC were identified. Antimicrobial stewardship interventions targeting penicillin allergy and carbapenem utilization were fully implemented in January 1, 2014...
November 3, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29053397/combined-intravitreal-and-systemic-antibiotic-therapy-in-a-patient-with-syphilitic-uveitis
#8
Arjun B Sood, William A Pearce, Kimberly A Workowski, James Lockwood, Steven Yeh
PURPOSE: To report the novel use of combined intravitreal and systemic antibiotic therapy in a patient with syphilitic panuveitis and discuss the management of ocular syphilis. METHODS: Case report Results: A 45-year old heterosexual male with human immunodeficiency virus (HIV) presented with 1 month of blurry vision in both eyes. Clinical examination revealed a bilateral panuveitis. The patient denied history of genital lesions or rash, but did complain of difficulty hearing bilaterally...
October 20, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/29032850/impact-of-penicillin-allergy-on-time-to-first-dose-of-antimicrobial-therapy-and-clinical-outcomes
#9
Erin L Conway, Ken Lin, John A Sellick, Kari Kurtzhalts, James Carbo, Michael C Ott, Kari A Mergenhagen
PURPOSE: The objective of this study was to evaluate the impact of a listed penicillin allergy on the time to first dose of antibiotic in a Veterans Affairs hospital. Additional clinical outcomes of patients with penicillin allergies were compared with those of patients without a penicillin allergy. METHODS: A retrospective chart review of veterans admitted through the emergency department with a diagnosis of pneumonia, urinary tract infection, bacteremia, and sepsis from January 2006 to December 2015 was conducted...
October 9, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/29028276/enhancing-antibiotic-stewardship-by-tackling-spurious-penicillin-allergy
#10
REVIEW
M T Krishna, A P Huissoon, M Li, A Richter, D G Pillay, D Sambanthan, S C Raman, S Nasser, S A Misbah
Approximately 90-99% of patients with a label of penicillin allergy (PenA) are not allergic when comprehensively investigated. An inaccurate label of PenA has major public health implications-longer hospital stay, more frequent hospital admissions, greater use of fluoroquinolones, glycopeptides, cephalosporins and other expensive antibiotics resulting in significantly higher costs to the health service and predisposing to Clostridium difficile, methicillin-resistant Staphylococcus aureus infections and vancomycin-resistant enterococcus...
November 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29026593/antibiotic-resistance-and-gyra-mutation-affect-the-efficacy-of-10-day-sitafloxacin-metronidazole-esomeprazole-therapy-for-helicobacter-pylori-in-penicillin-allergic-patients
#11
Hideki Mori, Hidekazu Suzuki, Juntaro Matsuzaki, Tatsuhiro Masaoka, Takanori Kanai
BACKGROUND AND AIM: Helicobacter pylori (H. pylori) eradication regimen has not been standardized for patients with penicillin allergy. We investigated the association between the efficacy of a 10-day sitafloxacin, metronidazole, and esomeprazole triple regimen and antibiotic resistance, in patients with penicillin allergy. METHODS: Penicillin-allergic patients infected with H. pylori were enrolled between March 2014 and November 2015. The minimum inhibitory concentrations (MICs) of sitafloxacin and metronidazole, and the gyrA mutation status of the H...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29017833/cross-reactivity-in-%C3%AE-lactam-allergy
#12
Robert J Zagursky, Michael E Pichichero
β-Lactam drugs (penicillins, amoxicillin, and cephalosporins) account for 42.6% of all severe drug-induced anaphylaxis. In this review, we focus on clinically significant immunologic cross-reactivity in patients with confirmed penicillin allergy to cephalosporins, and the structural involvement of the R1 and R2 chemical side chains of the cephalosporins causing IgE-mediated cross-reactivity with penicillin and other cephalosporins. Skin tests predict IgE-mediated reactions and showed cross-reactivity between penicillins and early generation cephalosporins that shared side chains, but confirmatory challenge data are lacking...
October 7, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28965632/penicillin-and-beta-lactam-hypersensitivity
#13
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/28958745/are-cephalosporins-safe-for-use-in-penicillin-allergy-without-prior-allergy-evaluation
#14
REVIEW
Eric Macy, Kimberly G Blumenthal
No abstract text is available yet for this article.
September 22, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28958738/the-cost-of-penicillin-allergy-evaluation
#15
Kimberly G Blumenthal, Yu Li, Aleena Banerji, Brian J Yun, Aidan A Long, Rochelle P Walensky
BACKGROUND: Unverified penicillin allergy leads to adverse downstream clinical and economic sequelae. Penicillin allergy evaluation can be used to identify true, IgE-mediated allergy. OBJECTIVE: To estimate the cost of penicillin allergy evaluation using time-driven activity-based costing (TDABC). METHODS: We implemented TDABC throughout the care pathway for 30 outpatients presenting for penicillin allergy evaluation. The base-case evaluation included penicillin skin testing and a 1-step amoxicillin drug challenge, performed by an allergist...
September 22, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28892222/oral-challenge-without-skin-tests-in-children-with-non-severe-beta-lactam-hypersensitivity-time-to-change-the-paradigm
#16
Luis Moral, Jean-Christoph Caubet
Suspected allergy to penicillins and cephalosporins is very common in childhood. After a proper evaluation, allergy will be confirmed only in a small portion of them. Intradermal tests are usually part of the allergy workup, but they are painful for children and time-consuming, and their role has been debated. A systematic review found only two studies reporting a positive predictive value of skin tests in children of 36% and 33%, respectively, leading to a high rate of inaccurate diagnosis. Moreover, considering that skin tests are negative in more than 90%-95% of cases, an oral provocation test (OPT) is finally needed to confirm tolerance in most of these children...
September 11, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28859210/oral-desensitization-to-penicillin-for-the-treatment-of-pregnant-women-with-syphilis-a-successful-program
#17
Jéssica Dallé, Mauro Cunha Ramos, Mirela Foresti Jimenez, Fernanda Garcia Escobar, Vicente Sperb Antonello
Gestational syphilis is a prevalent disease in Brazil and other low and medium income countries. Desensitization to penicillin is recommended for pregnant women with syphilis who are allergic to β-lactams. This is a descriptive study utilizing outpatient medical records from 2011 to 2015 from a mother and child hospital that is part of the national healthcare system in the South of Brazil, which performs an average of 3,600 birth assistances per year. All cases of pregnant women with syphilis and presumptive diagnosis of β-lactam allergy during the study period were included...
August 31, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28854276/a-significant-increase-in-the-pepsinogen-i-ii-ratio-is-a-reliable-biomarker-for-successful-helicobacter-pylori-eradication
#18
Hiroki Osumi, Junko Fujisaki, Takanori Suganuma, Yusuke Horiuchi, Masami Omae, Toshiyuki Yoshio, Akiyoshi Ishiyama, Tomohiro Tsuchida, Kazumasa Miki
BACKGROUND: Helicobacter pylori (H. pylori) eradication is usually assessed using the 13C-urea breath test (UBT), anti-H. pylori antibody and the H. pylori stool antigen test. However, a few reports have used pepsinogen (PG), in particular, the percentage change in the PG I/II ratio. Here, we evaluated the usefulness of the percentage changes in serum PG I/II ratios for determining the success of eradication therapy for H. pylori. MATERIALS AND METHODS: In total, 650 patients received eradication therapy from October 2008 to March 2013 in our Cancer Institute Hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28844171/a-clinical-decision-making-algorithm-for-penicillin-allergy
#19
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
https://www.readbyqxmd.com/read/28843308/most-children-labeled-as-penicillin-allergic-are-at-low-risk-for-true-penicillin-allergy
#20
Moshe Ben-Shoshan
No abstract text is available yet for this article.
September 2017: Journal of Pediatrics
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