Allergy to penicillin: fable or fact?

Surtees, S. J.; Stockton, Mike; Gietzen, Thorsten

doi:10.1136/bmj.302.6784.1051

Cited by 77 publications

(38 citation statements)

References 9 publications

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“…Several studies in this review confirm a very low rate of positive skin and radioallergosorbent tests (a blood test used to determine if a person is allergic to a specific substance) in those with a reported penicillin allergy (14,23). This is further supported by the work of Surtee et al, who studied 132 patients with a purported history of penicillin allergy (32). The allergy was confirmed by radioallergosorbent test in only 4 (3.03%) of the 132 patients.…”

Section: Discussionmentioning

confidence: 67%

The Use of Cephalosporins in Penicillin-allergic Patients: A Literature Review

Campagna

Bond

Schabelman

et al. 2012

The Journal of Emergency Medicine

181

113

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Section: Discussionmentioning

confidence: 67%

The Use of Cephalosporins in Penicillin-allergic Patients: A Literature Review

Campagna

Bond

Schabelman

et al. 2012

The Journal of Emergency Medicine

181

113

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“…In contrast, Kerr 5 considered only 1.11 % of hospital patients to be allergic to penicillins by history in a prospective survey without skin testing and Surtees et a1. 6 could confirm penicillin allergy in only 4 of 132 patients (3%) claiming penicillin allergy. Now it may be argued that negative skin testing for penicillin allergy in the absence of treatment with betalactams does not constitute irrefutable evidence for the absence of penicillin allergy.…”

Section: Discussionmentioning

confidence: 96%

The Value of Skin Testing for Penicillin Allergy in an Inpatient Population: Analysis of the Subsequent Patient Management

Warrington

Lee²,

McPhillips³

2000

allergy asthma proc

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It was decided to assess the value of skin testing in a group of inpatients with a remote history of penicillin allergy, in terms of whether or not beta-lactams were subsequently given, if any adverse reactions occurred as a result of this therapy, and if labeling of the patient record was changed subsequent to skin testing and/or challenge. All patients seen in consultation with a history of penicillin allergy were assessed. When done, skin tests were performed with the major and minor determinants of penicillin and semisynthetic penicillins. Charts were reviewed after discharge in terms of the antibiotics given during admission, adverse events, and the medical record and hospital database labeling for drug allergy at discharge. Skin testing was carried out in 79% of 67 patients assessed and in all, the tests were negative. Beta-lactam therapy was recommended in 51/53 patients but was given in only 57% of these cases. At discharge, 49% of patients' records still carried the penicillin allergy label, despite negative skin testing and/or successful completion of a course of beta-lactam therapy. So, in approximately half of the patients reviewed, beta-lactams were not given despite negative skin tests and a recommendation to do so, if indicated, and 49% of patients were still inappropriately labeled as being penicillin-allergic on discharge.

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“…While IAP during delivery is associated with declines in GBS streptococcal infections, there have also been reports of clusters or increases in Gram-negative infections among newborns as a result of increasing prophylactic treatment [59][60][61][62] . In addition, the incidence of penicillin allergy (allergic reactions of all severities), specifically in an obstetric population, has been reported to vary from 0.7 to 10% [63][64][65][66] . In order to minimize IAP while still providing optimal prevention of perinatal GBS infection in preterm neonates, it would be beneficial to screen for GBS colonization early in pregnancy, as the American Academy of Pediatrics recommended in 1992 [67,68] .…”

Section: Interpretation Of Resultsmentioning

confidence: 99%

Timing of Group B Streptococcus Screening in Pregnancy: A Systematic Review

Berg¹,

Houtman-Roelofsen²,

Oostvogel

et al. 2009

Gynecol Obstet Invest

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Background: Group B streptococcus (GBS) is an important cause of neonatal sepsis. Guidelines advise to collect cultures at 35–37 weeks’ gestation and to administer intrapartum antibiotic prophylaxis in case of GBS-positive cultures, as well as in all preterm deliveries. Improved effectiveness of antenatal cultures might help to further decrease GBS early-onset disease. Objective: To determine the best timing of antenatal cultures, which may help establish optimal prevention of perinatal GBS infection in both term and preterm neonates. Methods: PubMed and EMBASE databases were searched for relevant articles published from 1966 to February 2009. Nine articles were included. Information about study features and predictive values of antenatal cultures were abstracted. Results: Positive predictive values for antenatal GBS cultures ranged from 43 to 100% (mean 69%) and negative predictive values from 80 to 100% (mean 94%). GBS cultures collected in late pregnancy had high positive predictive values for colonization during delivery. The negative predictive value was high and relatively constant regardless of GA. Conclusions: This systematic review confirms recommendations to screen pregnant women for colonization of GBS at 35–37 weeks’ gestation, but one should be aware of the limitations of screening, with 6% of GBS carriers remaining undetected in antenatal cultures.

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Allergy to penicillin: fable or fact?

Cited by 77 publications

References 9 publications

The Use of Cephalosporins in Penicillin-allergic Patients: A Literature Review

The Use of Cephalosporins in Penicillin-allergic Patients: A Literature Review

The Value of Skin Testing for Penicillin Allergy in an Inpatient Population: Analysis of the Subsequent Patient Management

Timing of Group B Streptococcus Screening in Pregnancy: A Systematic Review

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