Management of patients with suspected or confirmed antibiotic allergy. Executive summary of guidance from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Allergy and Clinical Immunology (SEAIC), the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Intensive Medicine and Coronary Care Units (SEMICYUC)

Candent issues in pneumonia. Reflections from the Fifth Annual Meeting of Spanish Experts 2023

“…Allergy to beta-lactam antibiotics is a frequent problem among patients and in Spain it is estimated that a 10-12% of the population has some type of hypersensitivity and women are more often affected. Overall, 17% of all these adverse drug reactions are severe and 0.6% are the cause of death [ 56 , 57 ]. Clinical spectrum of allergic reactions is very wide.…”

“…Clinicians also must consider antibiotic coverage of S. aureus and/or P. aeruginosa if needed. If a beta-lactam antibiotic is used, they may perform a previous controlled exposition trial [ 56 ]. As it has been stated, it is important to eliminate false allergy labels and to stratify risk.…”

“…acillin-tazobactam and meropenem are less frequent, but their occurrence has been increased in last years and their severity is higher [58]. Moreover, people who are allergic to beta-lactam antibiotics have worse outcomes: they are more days in hospital, have higher rates of hospital readmission, costs, ICU stay and mortality; have more postsurgical complications and higher risk of Clostridioides difficile diarrhoea and multidrug resistant bacterial infections [56,59,60]. In addition, alternative antibiotics such as quinolones have an unfavourable adverse reaction profile, with publication of safety notes by regulatory agencies [61].…”

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“…This superstructure permits viral genetic material to be transported between cells without being released into the cellular space, resulting in a very efficient transmission system that also hides the virus from immune system action [55] (Figure 2). One implication of syncytia formation is that the peak viral load occurs later than in other viral infections that do not induce syncytia [56,57]. Another difference is that this type of virus progression appears to be a viral evasion strategy, with a direct impact on the severity of infection [55].…”

“…acillin-tazobactam and meropenem are less frequent, but their occurrence has been increased in last years and their severity is higher [58]. Moreover, people who are allergic to beta-lactam antibiotics have worse outcomes: they are more days in hospital, have higher rates of hospital readmission, costs, ICU stay and mortality; have more postsurgical complications and higher risk of Clostridioides difficile diarrhoea and multidrug resistant bacterial infections [56,59,60]. In addition, alternative antibiotics such as quinolones have an unfavourable adverse reaction profile, with publication of safety notes by regulatory agencies [61].…”