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https://www.readbyqxmd.com/read/28539186/a-survey-of-inpatient-practitioner-knowledge-of-penicillin-allergy-at-2-community-teaching-hospitals
#1
Mary L Staicu, Dipekka Soni, Kelly M Conn, Allison Ramsey
BACKGROUND: The negative effect of the penicillin allergy label on antibiotic use and patient outcomes has brought to light the need for thorough penicillin allergy assessments and heightened practitioner education. OBJECTIVE: To evaluate practitioner knowledge of penicillin allergy and the clinical approach to the patients with penicillin allergy. METHODS: An electronic survey was distributed to attending physicians, residents, pharmacists, nurse practitioners, and physician assistants practicing adult inpatient medicine at 2 community-based teaching hospitals from February to April 2016...
May 20, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28492106/higher-risk-of-revision-for-infection-using-systemic-clindamycin-prophylaxis-than-with-cloxacillin
#2
Otto Robertsson, Olof Thompson, Annette W-Dahl, Martin Sundberg, Lars Lidgren, Anna Stefánsdóttir
Background and purpose - Clindamycin has not been compared with other antibiotics for prophylaxis in arthroplasty. Since 2009, the Swedish Knee Arthroplasty Register (SKAR) has been collecting information on the prophylactic antibiotic regime used at every individual operation. In Sweden, when there is allergy to penicillin, clindamycin has been the recommended alternative. We examined whether there were differences in the rate of revision due to infection depending on which antibiotic was used as systemic prophylaxis...
May 11, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28483317/oral-challenge-without-skin-testing-safely-excludes-clinically-significant-delayed-onset-penicillin-hypersensitivity
#3
Ronit Confino-Cohen, Yossi Rosman, Keren Meir-Shafrir, Tali Stauber, Idit Lachover-Roth, Alon Hershko, Arnon Goldberg
BACKGROUND: Penicillins are the drug family most commonly associated with hypersensitivity reactions. Current guidelines recommend negative skin tests (ST) before re-administering penicillins to patients with previous nonimmediate reactions (NIR). OBJECTIVE: The objective of this study was to examine whether ST are necessary before re-administering penicillin to patients with NIR. METHODS: Patients with NIR to penicillins starting longer than 1 hour after last dose administration or starting any time after the first treatment day or patients with vague recollection of their reaction underwent penicillin ST...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28475731/evaluation-of-daptomycin-combinations-with-cephalosporins-or-gentamicin-against-streptococcus-mitis-group-strains-in-an-in-vitro-model-of-simulated-endocardial-vegetations-sevs
#4
Juwon Yim, Jordan R Smith, Nivedita B Singh, Seth Rice, Kyle Stamper, Cristina Garcia de la Maria, Arnold S Bayer, Nagendra N Mishra, José M Miró, Truc T Tran, Cesar A Arias, Paul Sullam, Michael J Rybak
Objectives: Among viridans group streptococcal infective endocarditis (IE), the Streptococcus mitis group is the most common aetiological organism. Treatment of IE caused by the S. mitis group is challenging due to the high frequency of β-lactam resistance, drug allergy and intolerability of mainstay antimicrobial agents such as vancomycin or gentamicin. Daptomycin has been suggested as an alternative therapeutic option in these scenarios based on its excellent susceptibility profile against S...
May 5, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28438590/antibiotic-prophylaxis-in-cataract-surgery-in-the-setting-of-penicillin-allergy-a-decision-making-algorithm
#5
REVIEW
Benjamin R LaHood, Nicholas Andrew, Michael Goggin
Cataract surgery is the most commonly performed surgical procedure in many developed countries. Post-operative endophthalmitis is a rare complication with potentially devastating visual outcomes. Currently, there is no global consensus regarding antibiotic prophylaxis in cataract surgery despite growing evidence of the benefits of prophylactic intracameral cefuroxime at the conclusion of surgery. The decision about which antibiotic regimen to use is further complicated in patients reporting penicillin allergy...
April 21, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28375803/routine-use-of-prophylactic-antibiotics-during-laparoscopic-cholecystectomy-does-not-reduce-the-risk-of-surgical-site-infections
#6
Pinar Sarkut, Sadik Kilicturgay, Hikmet Aktas, Yilmaz Ozen, Ekrem Kaya
BACKGROUND: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallbladder stones. As infections are rare in uncomplicated LC, it is widely accepted that prophylactic antibiotics need not be administered, and guidelines do not support routine antibiotic prophylaxis during elective LC. However, routine antibiotic prophylaxis for elective LC is still popular in many clinical settings. We investigated this situation in our department. METHOD: This randomized double-blind controlled study included 570 patients who underwent LC between March 2007 and February 2010...
April 4, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28370003/clinical-outcomes-following-inpatient-penicillin-allergy-testing-a-systematic-review-and-meta-analysis
#7
REVIEW
K A Sacco, A Bates, T J Brigham, J Saadi Imam, M Caroline Burton
BACKGROUND: A documented penicillin allergy is associated with increased morbidity including length of hospital stay and an increased incidence of resistant infections attributed to use of broader-spectrum antibiotics. The aim of the systematic review was to identify whether inpatient penicillin allergy testing affected clinical outcomes during hospitalization. METHODS: We performed an electronic search of Ovid MEDLINE/PubMed, Embase, Web of Science, Scopus, and the Cochrane Library over the past 20 years...
March 29, 2017: Allergy
https://www.readbyqxmd.com/read/28366717/the-effect-of-penicillin-allergy-testing-on-future-health-care-utilization-a-matched-cohort-study
#8
Eric Macy, Yu-Hsiang Shu
BACKGROUND: The effect that penicillin allergy testing has on future health care utilization is uncertain. OBJECTIVE: Determine whether penicillin allergy testing affects future overall health care utilization as measured by outpatient department (OPD) visits, emergency department (ED) visits, and hospital days. METHODS: Potential cases and control subjects were penicillin allergic Kaiser Permanente Southern California members who had at least 2 visits between 2010 and 2012 and at least 1 year of continuous health plan coverage before their index visit...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28282521/surgical-site-infections-in-patients-receiving-osteomyocutaneous-free-flaps-to-the-head-and-neck-does-choice-of-antibiotic-prophylaxis-matter
#9
James Murphy, Amal Isaiah, Donita Dyalram, Joshua E Lubek
PURPOSE: The most appropriate prophylactic antibiotic for clean-and-contaminated head and neck osteomyocutaneous free flap (OFF) tissue transfer procedures is unclear. The purpose of this study was to determine whether the choice of perioperative antibiotic was related to recipient surgical site infection (SSI) in patients receiving an OFF to the head and neck. MATERIALS AND METHODS: This retrospective cohort study evaluated SSI in relation to the perioperative antibiotic received from July 2010 through October 2013 at a tertiary care medical center...
February 16, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28254470/tackling-inpatient-penicillin-allergies-assessing-tools-for-antimicrobial-stewardship
#10
Kimberly G Blumenthal, Paige G Wickner, Shelley Hurwitz, Nicholas Pricco, Alexandra E Nee, Karl Laskowski, Erica S Shenoy, Rochelle P Walensky
BACKGROUND: Reported penicillin allergy rarely reflects penicillin intolerance. Failure to address inpatient penicillin allergies results in more broad-spectrum antibiotic use, treatment failures, and adverse drug events. OBJECTIVE: We aimed to determine the optimal approach to penicillin allergies among medical inpatients. METHODS: We evaluated internal medicine inpatients reporting penicillin allergy in 3 periods: (1) standard of care (SOC), (2) penicillin skin testing (ST), and (3) computerized guideline application with decision support (APP)...
February 28, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28179249/penicillin-skin-testing-as-an-antimicrobial-stewardship-initiative
#11
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/28164269/anaesthetic-hypersensitivity-reactions-in-france-between-2011-and-2012-the-10th-gerap-epidemiologic-survey
#12
C Tacquard, O Collange, P Gomis, J-M Malinovsky, N Petitpain, P Demoly, S Nicoll, P M Mertes
BACKGROUND: Immediate hypersensitivity reactions during anaesthesia are rare but potentially life-threatening. The epidemiology changes with time and evolving professional practice, and hence needs to be monitored. Our objective was to follow this epidemiology. METHODS: This was a retrospective, observational study in French hospital clinics, conducted by GERAP members (Groupe d'Étude des Réactions Anaphylactoïdes Périopératoires). Consecutive patients seen in allergo-anaesthesia outpatient clinics, who had experienced a hypersensitivity reaction during anaesthesia between 1 January 2011 and 31 December 2012, were included...
March 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28137938/repurposing-an-old-drug-aztreonam-as-a-new-treatment-strategy-for-gonorrhoea
#13
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/28077533/cefalotin-as-antimicrobial-prophylaxis-in-patients-with-known-intraoperative-anaphylaxis-to-cefazolin
#14
P H M Sadleir, R C Clarke, P R Platt
BACKGROUND: The most common trigger for intraoperative anaphylaxis in Western Australia for the period 2014-5 was an antibiotic used for surgical prophylaxis, cefazolin. In these patients who subsequently present for surgery, alternative cephalosporins are forbidden by current guidelines because of concerns regarding an increased risk of anaphylaxis. However, consideration of the structure-activity relationships relevant to anaphylaxis suggests that cefalotin is a safe alternative because of structural dissimilarities, although there are no pubished clinical data relevant to the perioperative setting...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077047/extended-infusion-compared-to-standard-infusion-cefepime-as-empiric-treatment-of-febrile-neutropenia
#15
Rebekah H Wrenn, David Cluck, LeAnne Kennedy, Christopher Ohl, John C Williamson
Background Extended infusion (EI) dosing provides a longer time above the minimum inhibitory concentration, which is important for the clinical success of β-lactam antibiotics, especially for patients with impaired immunity. The aim of this study was to determine the feasibility and clinical impact of administering cefepime by EI as treatment of febrile neutropenia. Methods This was a prospective, randomized, comparative pilot study. All patients received cefepime 2 g IV every 8 h, with the first dose administered using a 30-min infusion...
January 1, 2017: Journal of Oncology Pharmacy Practice
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
#16
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...
April 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27881151/gentamicin-versus-ceftriaxone-for-the-treatment-of-gonorrhoea-g-tog-trial-study-protocol-for-a-randomised-trial
#17
Clare Brittain, Margaret Childs, Lelia Duley, Jan Harding, Trish Hepburn, Garry Meakin, Alan A Montgomery, Wei Tan, Jonathan D C Ross
BACKGROUND: Gonorrhoea is a common sexually transmitted infection which causes genital pain and discomfort; in women it can also lead to pelvic inflammatory disease and infertility, and in men to epididymo-orchitis. Current treatment is with ceftriaxone, but there is increasing evidence of antimicrobial resistance which is reducing its effectiveness against gonorrhoea. A small, but increasing, number of patients have already been found to have highly resistant strains of gonorrhoea which has been associated with clinical failure...
November 24, 2016: Trials
https://www.readbyqxmd.com/read/27864093/skin-testing-and-drug-challenge-outcomes-in-antibiotic-allergic-patients-with-immediate-type-hypersensitivity
#18
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/27852424/hypersensitivity-to-beta-lactam-antibiotics-a-three-year-study
#19
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
#20
Jose A Cornejo-Garcia, Abderrahim Oussalah, Miguel Blanca, Rosa-Maria Gueant-Rodriguez, Cristobalina Mayorga, Julie Waton, Annick Barbaud, Francesco Gaeta, Antonino Romano, Jean-Louis Gueant
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...
2016: Current Pharmaceutical Design
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