Cross-reactivity and tolerability of aztreonam and cephalosporins in subjects with a T cell–mediated hypersensitivity to penicillins

Romano, Antonino; Gaeta, Francesco; Valluzzi, Rocco Luigi; Maggioletti, Michela; Quaratino, Donato

doi:10.1016/j.jaci.2016.01.025

Cited by 75 publications

(75 citation statements)

References 43 publications

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“…In the U.S., Antibiotic Stewardship recommends minimizing antibiotic use [12]. Thus, most U.S. allergists no longer prescribe multiple day provocative challenges to antibiotics in patients who do not require antibiotic therapy.…”

Section: Drug Provocation Testsmentioning

confidence: 99%

Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America

Torres

Romano

Çelik

et al. 2017

Clin Transl Allergy

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Drug hypersensitivity reactions (DHRs) affect an unknown proportion of the general population, and are an important public health problem due to their potential to cause life-threatening anaphylaxis and rare severe cutaneous allergic reactions. DHR evaluations are frequently needed in both ambulatory and hospital settings and have a complex diagnosis that requires a detailed clinical history and other tests that may include in vitro tests and in vivo procedures such as skin tests and drug provocation tests. Although over the years both European and U.S. experts have published statements on general procedures for evaluating DHRs, a substantial discordance in their daily management exists. In this review, we highlight both the differences and the similarities between the European and U.S. perspectives. While a general consensus exists on the importance of skin tests for evaluating DHRs, concordance between Americans and Europeans exists solely regarding their use in immediate reactions and the fact that a confirmation of a presumptive diagnosis by drug provocation tests is often the only reliable way to establish a diagnosis. Finally, great heterogeneity exists in the application of in vitro tests, which require further study to be well validated.

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Section: Drug Provocation Testsmentioning

confidence: 99%

Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America

Torres

Romano

Çelik

et al. 2017

Clin Transl Allergy

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“…Our study is the largest one to investigate cross‐reactivity among BL antibiotics in non‐immediate CADRs including severe CADRs (Table ) . It is also the first one with a clearly late notified delay of onset for patients with MPE …”

Section: Discussionmentioning

confidence: 99%

“…Our study is the largest one to investigate cross-reactivity among BL antibiotics in non-immediate CADRs including severe CADRs (Table 3). [14][15][16][17][18][19][20][21] It is also the first one with a clearly late notified delay of onset for patients with MPE. 13 We showed a high frequency of cross-reactions between BL subclasses (63.6% among test-positive patients) in non- For allergy to penicillin, we found cross-reactivity with cephalosporins in 3/18 (16.5%) BL-positive patients, in accordance with previous publications.…”

Section: Discussionmentioning

confidence: 99%

“…Non‐immediate CADRs include then a wide spectrum of CADRs, from late urticaria occurring a few hours after drug intake to maculopapular exanthema (MPE) and severe CADRs. However, published studies of BL‐induced non‐immediate CADRs included heterogeneous patients and mainly ‘erythema’ ‘oedema’, urticaria and MPE without data on the delay of onset . In contrast, few studies included patients with precise or severe phenotypes of late CADRs …”

Section: Introductionmentioning

confidence: 99%

“…However, published studies of BL-induced nonimmediate CADRs included heterogeneous patients and mainly 'erythema' 'oedema', urticaria and MPE without data on the delay of onset. [14][15][16][17][18][19][20] In contrast, few studies included patients with precise or severe phenotypes of late CADRs. [21][22][23] Cross-reactivity among BL is usually explored by skin tests, sometimes followed by rechallenges.…”

Section: Introductionmentioning

confidence: 99%

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Cross‐reactivity in beta‐lactams after a non‐immediate cutaneous adverse reaction: experience of a reference centre for toxic bullous diseases and severe cutaneous adverse reactions

Bérot¹,

Géner²,

Ingen‐Housz‐Oro

et al. 2019

Acad Dermatol Venereol

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Background Cross‐reactivity among beta‐lactam antibiotics (BL) is essentially reported in immediate hypersensitivity. Objectives To evaluate cross‐reactivity beyond BLs in patients with non‐immediate cutaneous adverse drug reaction (non‐immediate CADR) managed in a dermatology reference centre of toxic bullous and severe CADRs. Patients/Materials/Methods We conducted a retrospective single‐centre study in consecutive patients consulting between 2010 and 2018 with an active BL‐suspected non‐immediate CADR and explored by cutaneous tests [patch tests (PT) and intradermal tests (P‐IDR)] for at least three penicillin's subclasses and amino‐ and non‐amino‐cephalosporins (at least one aminocephalosporin). Cross‐reactivity among subclasses was investigated for patients with positive tests. Results We included 56 patients, among whom 46 amoxicillin‐suspected were and seven cephalosporin‐suspected. Twenty‐nine had severe CADR, and 27 had non‐immediate maculopapular exanthema (MPE). Twenty‐two had positive tests (18 for AS and four for CS). Among the 18 positive amoxicillin‐suspected, 10 (55.6%) showed cross‐reactivity with one or more other BL: 9 (50%) with another penicillin and 3 (16.5%) with a non‐aminocephalosporin. No amoxicillin‐ or cephalosporin‐suspected patient showed cross‐reactivity with aztreonam or carbapenems. P‐IDR showed cross‐reactivity only once. Conclusion After a suspected BL‐induced non‐immediate CADR, a large allergologic exploration is needed to confirm the diagnosis and evaluate cross‐reactivity. In our population including cases of severe CADRs and MPE with late delay of onset, cross‐reactivity was frequent and PT was sufficient to this purpose. The frequent cross‐reactivity among penicillins encourages stopping this whole family and to test cephalosporins, aztreonam and carbapenems for which cross‐allergies are rarer.

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Diagnosis and Treatment of Sexually Transmitted Infections

Tuddenham

Hamill

Ghanem

2022

JAMA

145

136

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In 2019, an estimated 2.55 million new sexually transmitted infections (STIs) were reported in the US, 1 with a projected direct medical cost of approximately $1.1 billion for gonorrhea, chlamydia, and syphilis in 2018. 2 In 2018, there were approximately 67.6 million prevalent infections in the US, suggesting that an estimated 1 in 5 adults had an STI. 3 People with STIs are at greater risk of transmitting HIV to others. Among people without HIV, STIs increase rates of HIV acquistion. 4,5 STIs also increase rates of infertility, chronic pelvic pain, ectopic pregnancy, miscarriage, fetal death, and congenital and neonatal infections. [6][7][8][9] This review summarizes current evidence regarding the epidemiology, diagnosis, treatment, and prevention of gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, trichomoniasis, and genital herpes. For the purposes of clarity, in this article, the terms male and female refer to those assigned male or female at birth, respectively (see eTable 1 in the Supplement for additional clinician resources). MethodsWe searched PubMed and Cochrane databases using Medical Subject Headings for English-language studies of the epidemiology, diagnosis, and treatment of gonorrhea, chlamydia (including lymphogranuloma venereum), syphilis, Mycoplasma genitalium, trichomoniasis, and herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) between October 1, 2010, and October 31, 2021. We manually searched the references of selected articles for additional relevant studies (including older studies). Randomized clinical trials, meta-analyses, systematic reviews, and national and international clinical practice guidelines were prioritized for inclusion. Of 1896 reports identified, 81 were included, consisting of 8 randomized trials, 7 meta-analyses, 27 systematic reviews, 5 clinical practice guidelines, 28 observational studies, 3 modeling studies, and 3 retrospective case series. IMPORTANCE Approximately 1 in 5 adults in the US had a sexually transmitted infection (STI) in 2018. This review provides an update on the epidemiology, diagnosis, and treatment of gonorrhea, chlamydia, syphilis, Mycoplasma genitalium, trichomoniasis, and genital herpes.OBSERVATIONS From 2015 to 2019, the rates of gonorrhea, chlamydia, and syphilis increased in the US; from 1999 to 2016, while the rates of herpes simplex virus type 1 (HSV-1) and HSV-2 declined. Populations with higher rates of STIs include people younger than 25 years, sexual and gender minorities such as men and transgender women who have sex with men, and racial and ethnic minorities such as Black and Latinx people. Approximately 70% of infections with HSV and trichomoniasis and 53% to 100% of extragenital gonorrhea and chlamydia infections are asymptomatic or associated with few symptoms. STIs are associated with HIV acquisition and transmission and are the leading cause of tubal factor infertility in women. Nucleic acid amplification tests have high sensitivities (86.1%-100%) and specificities (97.1%-100%) for the diagnosis of gonorrhea, chlamydia,...

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Cross-reactivity and tolerability of aztreonam and cephalosporins in subjects with a T cell–mediated hypersensitivity to penicillins

Cited by 75 publications

References 43 publications

Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America

Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America

Cross‐reactivity in beta‐lactams after a non‐immediate cutaneous adverse reaction: experience of a reference centre for toxic bullous diseases and severe cutaneous adverse reactions

Diagnosis and Treatment of Sexually Transmitted Infections

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