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Penicillin allergy

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https://www.readbyqxmd.com/read/29032850/impact-of-penicillin-allergy-on-time-to-first-dose-of-antimicrobial-therapy-and-clinical-outcomes
#1
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
#2
Mamidipudi Thirumala Krishna, Aarnoud P Huissoon, Mark Li, Alex Richter, Devadas Ganesh Pillay, Dhinakaran Sambanthan, Sumanth C Raman, Shuaib Nasser, Siraj 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, meticillin-resistant Staphylococcus aureus infections and vancomycin resistant enterococcus...
October 13, 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
#3
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
#4
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
#5
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
#6
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
#7
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-betalactam-hypersensitivity-time-to-change-the-paradigm
#8
Luis Moral, Jean-Cristoph 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
#9
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
#10
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
#11
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
#12
Moshe Ben-Shoshan
No abstract text is available yet for this article.
September 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28829234/proactive-penicillin-allergy-testing-in-primary-care-patients-labeled-as-allergic-outcomes-and-barriers
#13
Britta K Sundquist, Brady J Bowen, Uwa Otabor, Jocelyn Celestin, Paul C Sorum
OBJECTIVES: To promote penicillin allergy testing in an outpatient setting in patients labeled as penicillin allergic, to determine the number of those who are truly allergic, evaluate patient satisfaction with the testing, and educate both patients and clinicians about testing. METHODS: Patients with a history of penicillin allergy listed in their EHR were screened and recruited by their primary care office and referred for penicillin allergy testing. The results of allergy testing and patient satisfaction after testing were the main outcomes...
August 24, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28814358/frequency-of-selective-immediate-responders-to-aminopenicillins-and-cephalosporins-in-turkish-children
#14
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/28803185/risk-of-allergic-reactions-to-recurrent-intravenous-penicillin-administration-in-penicillin-skin-test-negative-patients
#15
Steve M Dorman, Sharon Seth, David A Khan
BACKGROUND: Patients with a history of penicillin allergy who are found to be skin test negative to penicillin are able to tolerate repeated oral doses of penicillin with low rates of resensitization. However, the resensitization rate after repeated doses of intravenous penicillin is less clear. OBJECTIVE: We sought to evaluate the risk of allergic reactions to repeated doses of intravenous penicillin in patients who previously reported penicillin allergy and were found to be penicillin skin test and oral challenge negative...
August 9, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28783775/low-grade-fever-erythematous-rash-in-pregnant-woman-%C3%A2-dx
#16
James M O'Brien, Jonathan D Baum
A 31-year-old woman presented to her obstetrician's office at 16 weeks' gestation with a 2-day history of low-grade fever and an erythematous rash measuring 1 x 4 cm on her right groin. She had a medical history of a penicillin allergy (urticarial) and her outdoor activities included gardening and picnicking. What's your diagnosis?
August 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28754406/antibiotic-use-in-2016-by-members-of-the-american-association-of-endodontists-report-of-a-national-survey
#17
Mark Germack, Christine M Sedgley, Wael Sabbah, Brian Whitten
INTRODUCTION: This study surveyed the antibiotic prescribing practices of endodontists, and data were compared with previous surveys conducted in 1994 and 1999. METHODS: A 17-question survey was sent via www.surveymonkey.com to 3000 active members of the American Association of Endodontists for responses about antibiotic prescribing practices and demographics. The data were analyzed using descriptive statistics, chi-square tests, and linear regression analyses...
October 2017: Journal of Endodontics
https://www.readbyqxmd.com/read/28754229/-hypersensitivity-reactions-to-beta-lactam-antibiotics
#18
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/28743423/utility-of-minor-determinants-for-skin-testing-in-inpatient-penicillin-allergy-evaluation
#19
Bob Geng, Jacqueline J Eastman, Karen Mori, Melinda Braskett, Marc A Riedl
BACKGROUND: Most patients with a history of penicillin allergy can tolerate penicillin. Skin testing can identify tolerant patients, but not all known allergenic determinants are commercially available. Protocols exist that use only available reagents, but the sensitivity and safety of these protocols, particularly for hospitalized patients, are controversial. OBJECTIVE: To determine the number of hospitalized patients referred for penicillin skin testing who showed unique positivity to the minor determinants penicilloate and penilloate...
September 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28742226/documentation-of-penicillin-adverse-drug-reactions-in-electronic-health-records-inconsistent-use-of-allergy-and-intolerance-labels
#20
Joshua M Inglis, Gillian E Caughey, William Smith, Sepehr Shakib
BACKGROUND: The majority of patients with penicillin allergy labels tolerate penicillins. Inappropriate avoidance of penicillin is associated with increased hospitalisation, infections and healthcare costs. AIMS: To examine the documentation of penicillin adverse drug reactions (ADR) in a large-scale hospital-based electronic health record. METHODS: Penicillin ADRs were extracted from 96,708 patient records in the Enterprise Patient Administration System in South Australia...
July 25, 2017: Internal Medicine Journal
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