Beta-lactam Allergy Review: Implications for Antimicrobial Stewardship Programs

Jones, Bruce M; Jozefczyk, Caroline; Maguire, Christina; Milliken, Stephanie; Weisz, E; Bland, Christopher M.

doi:10.1007/s40506-019-00186-5

Cited by 3 publications

(2 citation statements)

References 49 publications

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“…At these sites, the immune complexes activate complement and an inflammatory response that damages the tissue and impairs its function. Typically, type III hypersensitivities are not associated with beta-lactam exposure [5].…”

Section: Discussionmentioning

confidence: 99%

“…Outdated or inaccurate beta-lactam allergies can result in serious consequences, such as suboptimal antibiotic therapy, increased risk for adverse effects, and use of broader spectrum antibiotics than needed, which may contribute to antimicrobial resistance [5]. Pharmacists can play a vital role in evaluating the patient and identifying a true allergy, assisting in de-labeling inaccurate allergies, performing a standard of care skin test, deciding when desensitization is an appropriate option, and considering cross-reactivity for optimal antibiotic treatment.…”

Section: Introductionmentioning

confidence: 99%

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Overview of Beta-Lactam Allergy and the Role of the Pharmacist in Management

2021

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Unverified beta-lactam allergies are a substantial public health problem, as the majority of patients labeled as beta-lactam allergic do not have clinically significant allergies that may hinder the use beta-lactam therapy when indicated. Outdated or inaccurate beta-lactam or penicillin allergies can result in serious consequences, including suboptimal antibiotic therapy, increased risk of adverse effects, and use of broader spectrum antibiotics than indicated, which may contribute to antimicrobial resistance. The purpose of this review is to provide an overview of beta-lactam allergy and highlight the role of pharmacists in managing beta-lactam allergies. Studies have shown that pharmacists can play a vital role in allergy assessment, penicillin skin testing, beta-lactam desensitization, evaluation of beta-lactam cross-reactivity and recommending appropriate antibiotic therapy in patients with beta-lactam allergies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Overview of Beta-Lactam Allergy and the Role of the Pharmacist in Management

2021

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Antibiotic desensitization as a potential tool in antimicrobial stewardship programs: retrospective data analysis and systematic literature review

Rodriguez-Alarcón

Barceló-Vidal

Echeverría-Esnal

et al. 2022

Expert Review of Anti-infective Therapy

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Beta-Lactam Allergy De-labeling in a Pediatric Hospital

Meehl,

Salathe,

Cooley

et al. 2024

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVE To assess the ability to de-label pediatric patients of their beta-lactam allergy by using a newly implemented institutional protocol and to identify potential barriers to the de-labeling process. METHODS All patients with reported allergies to prespecified beta-lactam antibiotics were eligible for a beta-lactam allergy interview. Following the interview, patients were grouped into 4 risk categories—no risk, low risk, moderate risk, and high risk—and assessed for intervention eligibility. Potential interventions included de-labeling based on the interview alone or proceeding to an oral amoxicillin challenge with or without penicillin allergy skin testing. RESULTS Of the 62 patients eligible for beta-lactam allergy interviews, 40% (n = 25) were de-labeled. Among de-labeled patients, 60% (n = 15) were de-labeled on the basis of the interview alone. Additionally, no failures were documented in patients who underwent an oral amoxicillin challenge or penicillin skin testing. Barriers to performing oral amoxicillin challenges or penicillin skin testing included concomitant systemic steroid or antihistamine use, refusal of intervention, and insufficient resources to perform penicillin skin testing. CONCLUSIONS There was a high frequency of patients de-labeled of their beta-lactam allergies in this study. Increased education to patients, parents, and providers on the de-labeling process, as well as increased personnel available to coordinate and perform de-labeling interventions, may result in more beta-lactam allergy de-labeling.

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Beta-lactam Allergy Review: Implications for Antimicrobial Stewardship Programs

Cited by 3 publications

References 49 publications

Overview of Beta-Lactam Allergy and the Role of the Pharmacist in Management

Overview of Beta-Lactam Allergy and the Role of the Pharmacist in Management

Antibiotic desensitization as a potential tool in antimicrobial stewardship programs: retrospective data analysis and systematic literature review

Beta-Lactam Allergy De-labeling in a Pediatric Hospital

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