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Penicillin allergy

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https://www.readbyqxmd.com/read/29883754/a-retrospective-critical-analysis-and-risk-stratification-of-penicillin-allergy-de-labelling-in-a-uk-specialist-regional-allergy-service
#1
Omar E Mohamed, Sarah Beck, Aarnoud Huissoon, Cathryn Melchior, Jane Heslegrave, Richard Baretto, Anjali Ekbote, Mamidipudi Thirumala Krishna
BACKGROUND: A spurious label of penicillin allergy (Pen-A) negatively impacts on antibiotic stewardship and healthcare costs. Recent studies have proposed a guideline-steered direct penicillin challenge without undertaking allergy tests when 'true allergy' is unlikely. OBJECTIVE: Critically analyse Pen-A clinical presentation, perform risk stratification and determine clinical predictors for 'true allergy'. METHOD: Retrospective data extraction from clinical and electronic patient records...
June 5, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29803713/prospective-assessment-of-diagnostic-tests-for-pediatric-penicillin-allergy-from-clinical-history-to-challenge-tests-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2
#2
María Dolores Ibáñez, Pablo Rodríguez Del Río, Eva Maria Lasa, Alejandro Joral, Javier Ruiz-Hornillos, Candelaria Muñoz, Carmen Gómez Traseira, Carmelo Escudero, Jose María Olaguibel Rivera, Teresa Garriga-Baraut, David González-de-Olano, Ana Rosado, Silvia Sanchez-García, Socorro Pérez Bustamante, Maria Antonia Padial Vilchez, Patricia Prieto Montaño, Rocío Candón Morillo, Eva Macías Iglesia, Angélica Feliú Vila, Teresa Valbuena, Ana Lopez-Patiño, Antonio Martorell, Joaquín Sastre, María Teresa Audícana
BACKGROUND: Diagnostic guidelines for penicillin allergy in children recommend cumbersome protocols based partially on data from adults, which may be suboptimal for pediatric use. OBJECTIVE: To assess the accuracy of tools for diagnosis of penicillin allergy in children. METHODS: A prospective multicenter study was conducted in children with reported adverse events related to penicillin, excluding severe reactions. All patients underwent a uniform diagnostic protocol consisting of clinical history, skin tests, serum specific IgE, and, regardless of these results, drug provocation tests (DPT)...
May 24, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29802906/safety-and-outcomes-of-oral-graded-challenges-to-amoxicillin-without-prior-skin-testing
#3
Melissa Iammatteo, Santiago Alvarez Arango, Denisa Ferastraoaru, Nadeem Akbar, Andrew Y Lee, Hillel W Cohen, Elina Jerschow
BACKGROUND: Unconfirmed penicillin allergy poses substantial public health consequences. The most widely accepted protocol to evaluate penicillin allergy is skin testing followed by amoxicillin challenge. OBJECTIVE: To evaluate the safety of direct oral graded challenges to amoxicillin. METHODS: Prospective single-blind clinical trial with historical controls of patients ≥ 7 years old with historical non-life-threatening reactions to penicillin...
May 23, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29800754/long-term-follow-up-after-penicillin-allergy-de-labeling-in-ambulatory-patients
#4
Idit Lachover, Shoshan Sharon, Yossi Rosman, Keren Meir-Shafrir, Ronit Confino-Cohen
BACKGROUND: Unverified penicillin allergy label has negative health implications. To address this, several de-labeling methods have been proposed. OBJECTIVE: To appraise the long term outcomes of the penicillin allergy evaluation in ambulatory patients, focusing on subsequent use of penicillins in individuals found not allergic. A secondary objective was to examine the consistency between the evaluation's recommendations and the allergy label. METHODS: A retrospective medical records review and phone survey were carried out in ambulatory patients that were evaluated for suspected penicillin allergy in our allergy unit...
May 22, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29788022/hospitalizations-in-children-with-a-penicillin-allergy-label-an-assessment-of-healthcare-impact
#5
Bernardo Sousa-Pinto, Luís Araújo, Alberto Freitas, Luís Delgado
BACKGROUND: Beta-lactam allergy is overdiagnosed. Diagnosis of penicillin allergy has been associated with a greater use of hospital resources and an increased risk of antibiotic-resistant infections, although this issue remains poorly studied in children. We aimed to compare patient characteristics and use of hospital resources in hospitalized children with and without a record of penicillin allergy. METHODS: We identified all hospitalizations in children labelled as being allergic to penicillin in a database containing all hospitalizations in Portuguese public hospitals between 2000 and 2014, and compared these with a similar number of age-, sex-, and main diagnosis-matched hospitalizations without a penicillin allergy label...
May 22, 2018: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/29757781/misconceptions-surrounding-penicillin-allergy-implications-for-anesthesiologists
#6
Leon Vorobeichik, Elizabeth A Weber, Jordan Tarshis
Administration of preoperative antimicrobial prophylaxis, often with a cephalosporin, is the mainstay of surgical site infection prevention guidelines. Unfortunately, due to prevalent misconceptions, patients labeled as having a penicillin allergy often receive alternate and less-effective antibiotics, placing them at risk of a variety of adverse effects including increased morbidity and higher risk of surgical site infection. The perioperative physician should ascertain the nature of previous reactions to aid in determining the probability of the prevalence of a true allergy...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29751965/de-labeling-of-%C3%AE-lactam-allergy-reduces-intraoperative-time-and-optimizes-choice-in-antibiotic-prophylaxis
#7
Yara Moussa, Joseph Shuster, Gilbert Matte, Andrew Sullivan, Robert H Goldstein, Dayle Cunningham, Moshe Ben-Shoshan, Gabriele Baldini, Francesco Carli, Christos Tsoukas
BACKGROUND: Suspected penicillin allergic individuals receive suboptimal non-β-lactams for intraoperative prophylaxis which may prolong operations and have negative clinical outcomes. We therefore studied if β-lactam de-labeling optimized choice of prophylactic antibiotics and improved intraoperative time efficiency. METHODS: A multistep approach was used. It included a risk assessment tool by an allergist, β-lactam skin testing and oral provocation. To determine the value of de-labeling, we appraised intraoperative antibiotic choices and correlated them with time to first incision...
May 8, 2018: Surgery
https://www.readbyqxmd.com/read/29751152/the-use-of-telemedicine-for-penicillin-allergy-skin-testing
#8
Mary L Staicu, Anne Marie Holly, Kelly M Conn, Allison Ramsey
BACKGROUND: Penicillin skin testing (PST) is increasingly utilized as a tool to evaluate penicillin allergy in patients with a reported history. The limited availability of allergists, however, may be an impeding factor. OBJECTIVE: We sought to assess the clinical utility of telemedicine to facilitate PST. METHODS: Penicillin allergic inpatients receiving systemic antibiotics were prospectively identified between April and August 2017. Qualifying patients underwent PST performed by a trained Allergy/Immunology physician assistant (PA)...
May 8, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29747969/the-penicillin-allergy-label-expensive-to-maintain-inexpensive-to-remove
#9
EDITORIAL
Akilah A Jefferson, David A Khan, Marcus S Shaker
No abstract text is available yet for this article.
May 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29700201/antibiotic-allergy-in-pediatrics
#10
REVIEW
Allison Eaddy Norton, Katherine Konvinse, Elizabeth J Phillips, Ana Dioun Broyles
The overlabeling of pediatric antibiotic allergy represents a huge burden in society. Given that up to 10% of the US population is labeled as penicillin allergic, it can be estimated that at least 5 million children in this country are labeled with penicillin allergy. We now understand that most of the cutaneous symptoms that are interpreted as drug allergy are likely viral induced or due to a drug-virus interaction, and they usually do not represent a long-lasting, drug-specific, adaptive immune response to the antibiotic that a child received...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29696736/bismuth-improves-efficacy-of-proton-pump-inhibitor-clarithromycin-metronidazole-triple-helicobacter-pylori-therapy-despite-a-high-prevalence-of-antimicrobial-resistance
#11
Xiaohua Long, Qi Chen, Lou Yu, Xiao Liang, Wenzhong Liu, Hong Lu
BACKGROUND: Helicobacter pylori (H. pylori) eradication has become increasingly difficult especially for penicillin allergy patients. AIMS: To evaluate the efficacy of adding bismuth or high-dose metronidazole to an H. pylori eradication regimen containing a proton-pump inhibitor, clarithromycin, and metronidazole in patients allergic to penicillin. METHODS: Pilot study in which penicillin-allergic, treatment-naive subjects were randomized (1:1) to 14-day esomeprazole (20 mg q12h), clarithromycin (500 mg q12h), and high dose of metronidazole (400 mg q6h) with (BECM group) or without (ECM group) bismuth (600 mg q12h)...
April 25, 2018: Helicobacter
https://www.readbyqxmd.com/read/29695102/dendrimeric-antigens-for-drug-allergy-diagnosis-a-new-approach-for-basophil-activation-tests
#12
Noemi Molina, Angela Martin-Serrano, Tahia D Fernandez, Amene Tesfaye, Francisco Najera, María J Torres, Cristobalina Mayorga, Yolanda Vida, Maria I Montañez, Ezequiel Perez-Inestrosa
Dendrimeric Antigens (DeAns) consist of dendrimers decorated with multiple units of drug antigenic determinants. These conjugates have been shown to be a powerful tool for diagnosing penicillin allergy using in vitro immunoassays, in which they are recognized by specific IgE from allergic patients. Here we propose a new diagnostic approach using DeAns in cellular tests, in which recognition occurs through IgE bound to the basophil surface. Both IgE molecular recognition and subsequent cell activation may be influenced by the tridimensional architecture and size of the immunogens...
April 24, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29678929/antibiotic-use-after-removal-of-penicillin-allergy-label
#13
David Vyles, Asriani Chiu, John Routes, Mariana Castells, Elizabeth J Phillips, Jennifer Kibicho, David C Brousseau
BACKGROUND: Penicillin allergy is commonly reported in the pediatric emergency department. We previously performed 3-tier penicillin allergy testing on children with low-risk symptoms, and 100% tolerated a penicillin challenge without an allergic reaction. We hypothesized that no serious allergic reactions would occur after re-exposure to penicillin and that prescription practices would change after testing. METHODS: We performed a follow-up case series of 100 children whose test results were negative for penicillin allergy...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29670780/syphilis-related-eye-disease-presenting-as-bilateral-papilledema-retinal-nerve-fiber-layer-hemorrhage-and-anterior-uveitis-in-a-penicillin-allergic-patient
#14
Jamie Dietze, Shane Havens
Purpose . Treponema pallidum is known as the "great masquerader" for its many presentations and ocular findings in patients who are infected and develop secondary and tertiary stage of syphilis. Syphilitic ocular manifestations include uveitis, chorioretinitis, retinitis, vasculitis, vitritis, and panuveitis all with or without decreased visual acuity. Human immunodeficiency virus (HIV) is known to expedite the progression of syphilis when patients are coinfected, thus compounding the potential ophthalmic presentations...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29669670/utilization-and-timeliness-of-an-inpatient-penicillin-allergy-evaluation
#15
Keith A Sacco, Razvan Chirila, Claudia Libertin, Brett Hiroto, Arveen Bhasin, Margaret M Johnson, Thanai Pongdee, M Caroline Burton
BACKGROUND: A history of penicillin allergy is associated with an increased risk of nosocomial infections because patients are exposed to non-beta lactam antibiotics. Ruling out inaccurate penicillin allergy during hospitalization decreases prescription of beta lactam antibiotics. However, the utilization of penicillin allergy testing and timeliness in relation to initiation of antibiotics is not known. OBJECTIVE: Our aim was to describe the proportion and characteristics of patients who underwent inpatient penicillin allergy testing in a hospital without a guideline or infrastructure for inpatient penicillin allergy testing...
May 1, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29666785/risk-evaluation-of-endoscopic-retrograde-cholangiopancreatography-related-contrast-media-allergic-like-reaction-a-single-centre-experience
#16
Félix Trottier-Tellier, Laurence Harvey, Jean-Daniel Baillargeon
Background and Aims. Few cases of endoscopic retrograde cholangiopancreatography- (ERCP-) related contrast media (CM) adverse reactions have been reported in the current literature. There is a lack of standardisation in practice regarding premedication prophylaxis for at-risk patients undergoing ERCP and there are few data to guide the practitioners. Our goal is to evaluate the risk of CM adverse reaction in a group of patients with a past history of allergic-like reaction to iodine product undergoing ERCP...
2018: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29665345/evaluation-of-ifn-%C3%AE-enzyme-linked-immunospot-assay-elispot-as-a-first-line-test-in-the-diagnosis-of-non-immediate-hypersensitivity-to-amoxicillin-and-penicillin
#17
Lenka Sedláčková, Miroslav Průcha, Ingrid Poláková, Blanka Míková
The current diagnostic algorithm for beta-lactam allergy is based on skin and provocation tests, both of which carry a certain risk of inducing hypersensitivity reactions. Thus, non-invasive in vitro tests reliable enough to replace skin and provocation tests at least in a portion of patients are desirable. We aimed to verify the utility of IFN-γ ELISPOT as a first-line test in patients with suspected non-immediate hypersensitivity reaction to amoxicillin (AMX) and penicillin (PNC). The prospective observational study included 24 patients with recent, suspected non-immediate hypersensitivity reaction to AMX or PNC and 6 recently-exposed healthy subjects...
2018: Prague Medical Report
https://www.readbyqxmd.com/read/29594180/influence-of-reported-penicillin-allergy-on-mortality-in-mssa-bacteremia
#18
Nicholas A Turner, Rebekah Moehring, Christina Sarubbi, Rebekah H Wrenn, Richard H Drew, Coleen K Cunningham, Vance G Fowler, Deverick J Anderson
Background: Penicillin allergy frequently impacts antibiotic choice. As beta-lactams are superior to vancomycin in treating methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia, we examined the effect of reported penicillin allergy on clinical outcomes in patients with MSSA bacteremia. Methods: In this retrospective cohort study of adults with MSSA bacteremia admitted to a large tertiary care hospital, outcomes were examined according to reported penicillin allergy...
March 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29551402/systematic-review-of-professional-liability-when-prescribing-beta-lactams-for-patients-with-a-known-penicillin-allergy
#19
REVIEW
Meghan N Jeffres, Elizabeth A Hall-Lipsy, S Travis King, John D Cleary
OBJECTIVE: To describe medical negligence and malpractice cases in which a patient with a known penicillin allergy received a beta-lactam and experienced an adverse reaction related to the beta-lactam. DATA SOURCES: Lexis-Nexus, Westlaw, and Google Scholar were searched. STUDY SELECTIONS: Medical negligence and malpractice cases were eligible for inclusion if they met the following criteria: the plaintiff had a known penicillin allergy, received a beta-lactam, and experienced an adverse event...
March 15, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29542036/prevalence-and-characteristics-of-hospital-inpatients-with-reported-fluoroquinolone-allergy
#20
Geoffrey C Wall, Matthew J Taylor, Hayden L Smith
Background Fluoroquinolone (quinolones) antibiotics are commonly prescribed worldwide. Hypersensitivity reactions to these agents have been reported, but little systematic data exists concerning prevalence, types of reactions, or associated factors. Objective To identify the prevalence of patients reporting an allergy to quinolones, types of reactions claimed, and patient information associated with allergy. Setting A tertiary 370 bed level 1 trauma center, located in a Midwestern City in the United States...
March 14, 2018: International Journal of Clinical Pharmacy
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