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Cephalosporin allergy

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https://www.readbyqxmd.com/read/29028276/enhancing-antibiotic-stewardship-by-tackling-spurious-penicillin-allergy
#1
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/29017833/cross-reactivity-in-%C3%AE-lactam-allergy
#2
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
#3
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
#4
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/28892222/oral-challenge-without-skin-tests-in-children-with-non-severe-betalactam-hypersensitivity-time-to-change-the-paradigm
#5
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/28818054/comparison-of-the-trapezius-and-the-adductor-pollicis-muscle-as-predictor-of-good-intubating-conditions-a-randomized-controlled-trial
#6
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
BACKGROUND: Adequate muscle relaxation is important for ensuring optimal conditions for intubation. Although acceleromyography of the adductor pollicis muscle is commonly used to assess conditions for intubation, we hypothesized that acceleromyography of the trapezius is more indicative of optimal intubating conditions. The primary outcome was the difference between both measurement sites with regard to prediction of good or acceptable intubating conditions. METHODS: Neuromuscular blockade after injection of rocuronium 0...
August 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28814358/frequency-of-selective-immediate-responders-to-aminopenicillins-and-cephalosporins-in-turkish-children
#7
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/28577519/drug-allergy-evaluation-for-betalactam-hypersensitivity-cross-reactivity-with-cephalosporines-carbapenems-and-negative-predictive-value
#8
Mona Al-Ahmad, Tito Rodriguez-Bouza
BACKGROUND: There are no studies on cross-reactivity of betalactams among patients allergic to penicillin, or on the negative predictive value (NPV) of penicillin allergy evaluation from Arabian Gulf countries OBJECTIVE: We aimed to assess the role and NPV of drug provocation test (DPT) for betalactam hypersensitivity reactions in patients referred for allergy evaluation in Kuwait METHODS: Skin test (ST) was performed for all patients with a history of betalactam hypersensitivity, other than anaphylaxis...
June 1, 2017: Asian Pacific Journal of Allergy and Immunology
https://www.readbyqxmd.com/read/28539186/a-survey-of-inpatient-practitioner-knowledge-of-penicillin-allergy-at-2-community-teaching-hospitals
#9
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...
July 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
#10
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...
October 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28483317/oral-challenge-without-skin-testing-safely-excludes-clinically-significant-delayed-onset-penicillin-hypersensitivity
#11
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
#12
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...
August 1, 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
#13
REVIEW
Benjamin R LaHood, Nicholas H Andrew, Michael Goggin
Cataract surgery is the most commonly performed surgical procedure in many developed countries. Postoperative 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...
September 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
#14
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...
July 2017: Surgical Infections
https://www.readbyqxmd.com/read/28370003/clinical-outcomes-following-inpatient-penicillin-allergy-testing-a-systematic-review-and-meta-analysis
#15
REVIEW
K A Sacco, A Bates, T J Brigham, J S Imam, M C 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...
September 2017: Allergy
https://www.readbyqxmd.com/read/28366717/the-effect-of-penicillin-allergy-testing-on-future-health-care-utilization-a-matched-cohort-study
#16
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
#17
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...
October 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28254470/tackling-inpatient-penicillin-allergies-assessing-tools-for-antimicrobial-stewardship
#18
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)...
July 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28179249/penicillin-skin-testing-as-an-antimicrobial-stewardship-initiative
#19
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
#20
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
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