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Penicillin allergy

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
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
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
Emily L Heil, Jacqueline T Bork, Sarah A Schmalzle, Michael Kleinberg, Anupama Kewalramani, Bruce L Gilliam, Ulrike K Buchwald
Background.  A large percentage of patients presenting to acute care facilities report penicillin allergies that are associated with suboptimal antibiotic therapy. Penicillin skin testing (PST) can clarify allergy histories but is often limited by access to testing. We aimed to implement an infectious diseases (ID) fellow-managed PST program and to assess the need for PST via national survey. Methods.  We conducted a prospective observational study of the implementation of an ID fellow-managed penicillin allergy skin testing service...
September 2016: Open Forum Infectious Diseases
Dubravka Negovetić Vranić, Josipa Jurković, Jesenka Jeličić, Antonija Balenović, Gordana Stipančić, Ivana Čuković-Bagić
Medical emergencies that are life threatening can occur in dental practice. Complications may arise because of an underlying disease or a reaction to medication. Reactions to medications may be allergic and toxic. The most common reactions are toxic reactions to local anesthetics, whereas allergies occur mainly as a consequence of the application of antibiotics, usually penicillin. In response to stress, vasovagal syncope typically occurs. Other causes may be related to an underlying disease-specific pathology (such as acute asthma attack, diabetic ketoacidosis, hypoglycemia, or seizures) or accidents (aspiration of a foreign body causing obstruction of the respiratory system)...
March 2016: Acta Stomatologica Croatica
David French, Mehdi Noroozi, Batoul Shariati, Hannu Larjava
OBJECTIVE: The aim of this retrospective study was to investigate whether self-reported allergy to penicillin may contribute to a higher rate of postsurgical infection and implant failure. METHOD AND MATERIALS: This retrospective, non-interventional, open cohort study reports on implant survival and infection complications of 5,576 implants placed in private practice by one periodontist, and includes 4,132 implants that were followed for at least 1 year. Logistic regression was applied to examine the relationship between self-reported allergy to penicillin and implant survival, while controlling for potential confounders such as smoking, implant site, bone augmentation, loading protocol, immediate implantation, and bone level at baseline...
September 26, 2016: Quintessence International
Philip R Cohen
BACKGROUND:  Bullous impetigo results from Staphylococcus aureus (S. aureus) release of exfoliative toxins type A and type B thatresults in flaccid, easily ruptured, bullae in the upper layers of the epidermis.  Physiologic, gestation-associated, and incidental skin changes can occur in pregnancy.  Blisters in pregnant women can occur secondary to either common skin disorders orspecific dermatoses of pregnancy. PURPOSE:  To describe a pregnant woman with bullous impetigo and review bullous conditions in pregnant women...
2016: Dermatology Online Journal
Juan Meng, David Thursfield, Joanna J Lukawska
BACKGROUND: Penicillin allergy is associated with increased antibiotic resistance and health care costs. However, most patients with self-reported penicillin allergy are not truly allergic. OBJECTIVE: To summarize our experience with allergy tests in patients with a history of penicillin allergy and to compare them with the results of other groups. METHODS: We retrospectively reviewed all patients with a suspected clinical history of penicillin allergy referred to the Drug Allergy Unit at University College London Hospital between March 2013 and June 2015...
September 2016: Annals of Allergy, Asthma & Immunology
Jesse E Otero, Christopher M Graves, Yubo Gao, Tyler S Olson, Christopher C Dickinson, Rhonda J Chalus, David A Vittetoe, Devon D Goetz, John J Callaghan
BACKGROUND: Retrospective analyses have demonstrated correlation between patient-reported allergies and negative outcomes after total joint arthroplasty. We sought to validate these observations in a prospective cohort. METHODS: One hundred forty-four patients undergoing total hip arthroplasty and 302 patients undergoing total knee arthroplasty were prospectively enrolled. Preoperatively, patients listed their allergies and completed the Medical Outcomes Study Short Form 36 (SF-36) and the Charlson Comorbidity Index (CCI) Questionnaire...
August 10, 2016: Journal of Arthroplasty
A G Hirsch, J Pollak, T A Glass, M N Poulsen, L Bailey-Davis, J Mowery, B S Schwartz
BACKGROUND: Antibiotic use in early life has been linked to disruptions in the microbiome. Such changes can disturb immune system development. Differences have been observed in the microbiota of children with and without allergies, but there have been few studies on antibiotic use and allergic disease. OBJECTIVE: We evaluated associations of early-life antibiotic use with subsequent occurrence of food allergy and other allergies in childhood using electronic health record data...
August 26, 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Kaddy Juliana Beltrán-Sierra, Jorge Sánchez, Ricardo Cardona
BACKGROUND: Reactions to beta-lactams are frequent and it is difficult to establish the relationship between the drug and symptoms. OBJECTIVE: To describe the clinical characteristics and explore the immunological mechanisms of patients with suspected adverse reaction to beta-lactams. METHODS: Retrospective study of patients with a history of beta-lactam reaction and tests for reactions to drugs. RESULTS: Out of 125 patients, 71 were women (56...
July 2016: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
Susanna Esposito, Luca Castellazzi, Claudia Tagliabue, Nicola Principi
Antibiotics are the most prescribed drugs for children, and a relevant number of prescriptions are associated with the emergence of adverse events. Allergic reactions are the most frequently reported adverse events, with an incidence of up to 10% of all prescriptions. However, literature analysis has shown that allergy to antibiotics is generally overdiagnosed in children because in most cases the diagnosis is based only on the clinical history without a full allergy work-up. Consequently, children are often improperly deprived of narrow-spectrum antibiotics because of a suspected allergy to these drugs...
October 2016: International Journal of Antimicrobial Agents
Noémie Scornet, Sandrine Delarue-Cochin, Marie-Eliane Azoury, Maxime Le Mignon, Julie-Anne Chemelle, Emmanuel Nony, Bernard Maillere, Raphael Terreux, Marc Pallardy, Delphine Joseph
β-Lactam antibiotics allergy is recognized as a public health concern. By covalently binding to serum proteins, penicillins are known to form immunogenic complexes. The latter are recognized and digested by antigen-presenting cells into drug-hapten peptides leading to the immunization of treated persons and IgE-mediated hypersensitivity reactions encompassing anaphylaxis. If type I allergic reactions to drugs are often unpredictable, they are known to be dependent on CD4+ T-cells. This fundamental study revisits the chemical basis of the benzylpenicillin (BP) allergy with the aim of identifying immunologically relevant biomimetic benzylpenicilloylated peptides through the analysis of BP-conjugated human serum albumin (BP-HSA) profile and the evaluation of the naïve CD4+ T-cell responses to candidate BP-HSA-derived peptides...
August 23, 2016: Bioconjugate Chemistry
Konstantinos Tourlas, Deepa Burman
Allergic diseases are common in outpatient primary care. Allergy testing can guide management to determine allergy as a cause of symptoms and target therapeutic interventions. This article provides a review of common methods of allergy testing available so that physicians may counsel and refer patients appropriately. Immediate-type hypersensitivity skin tests can be used for airborne allergens, foods, insect stings, and penicillin. Radioallergosorbent testing can be used to evaluate immediate-type hypersensitivity...
September 2016: Primary Care
Brittany Knezevic, Dustin Sprigg, Jason Seet, Michelle Trevenen, Jason Trubiano, William Smith, Yogesh Jeelall, Sandra Vale, Richard Loh, Andrew McLean-Tooke, Michaela Lucas
BACKGROUND: Patients frequently report antibiotic allergies, however only 10% of labelled patients have a true allergy. AIM: We investigated the documentation of antibiotic "allergy" labels (AALs) and the effect of labelling on clinical outcomes, in a West Australian adult tertiary hospital. METHODS: Retrospective cross-sectional analysis of patients captured in the 2013 and 2014 National Antimicrobial Prescribing Surveys. Data was collected on documented antibiotic adverse drug reactions, antibiotic cost, prescribing appropriateness, prevalence of multi-drug resistant organisms, length of stay, intensive care admission, and readmissions...
August 17, 2016: Internal Medicine Journal
J A Trubiano, L J Worth, K Urbancic, T M Brown, D L Paterson, M Lucas, E Phillips
BACKGROUND: 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), Australasian Society of Infectious Diseases (ASID) and Society of Hospital Pharmacists Australia (SHPA)...
August 16, 2016: Internal Medicine Journal
C D Wear, C V Towers, M S Brown, B Weitz, S Porter, L Wolfe
OBJECTIVE: To evaluate maternal and neonatal cord blood levels at delivery in patients receiving 900 mg of clindamycin intravenous (IV) every 8 h. STUDY DESIGN: Prospective study consented every mother that entered labor with a positive group B streptococcal culture, a high-risk penicillin allergy, and sensitivity to clindamycin and erythromycin. Maternal and cord blood clindamycin levels were obtained at delivery. Time from last dose completion to delivery, number of doses administered and body mass index (BMI) were assessed...
August 4, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Cédric Hirzel, Lea Hirzberger, Hansjakob Furrer, Andrea Endimiani
Aerococcus urinae can cause severe infections (bacteraemia and endocarditis) that are associated with high mortality. However, data on the bactericidal and synergistic activity for clinically implemented antibiotics are scarce. Time-kill analyses were performed on two clinical isolates (AU1 and AU2) and the reference strain ATCC 700306 for penicillin (PG), ceftriaxone (CRO), gentamicin (GEN), daptomycin (DAP) and their combinations. AU1 and AU2 were CRO-resistant (MICs, 2 µg/mL) and ATCC 700306 was high-level GEN-resistant (MIC, 512 µg/mL), whereas all strains were PG- and DAP-susceptible (MICs, ≤0...
September 2016: International Journal of Antimicrobial Agents
Kimberly G Blumenthal, Erica S Shenoy, Mingshu Huang, James L Kuhlen, Winston A Ware, Robert A Parker, Rochelle P Walensky
BACKGROUND: Methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia is a morbid infection with mortality benefit from receipt of parenteral β-lactam therapy. A substantial portion of MSSA bacteremia patients report penicillin allergy, but infrequently have true allergy. OBJECTIVE: To determine the frequency and predictors of optimal and adequate therapy in patients with MSSA bacteremia. DESIGN: Retrospective cohort. PARTICIPANTS: Adult inpatients with MSSA bacteremia, January 2009 through October 2013...
2016: PloS One
Fernando Baquero-Artigao, Antonio Michavila, Ángeles Suárez-Rodriguez, Anselmo Hernandez, Leticia Martínez-Campos, Cristina Calvo
The suspected allergy to beta-lactam antibiotics, especially penicillin and amoxicillin, is the most frequent reason for consultation in Child Allergy Units. In this consensus document, the clinical and diagnostic criteria of allergic reactions are described, as well as alternative antibiotic treatment for the most common infections diagnosed in paediatrics for patients with known or suspected allergy.
July 14, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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