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Skin testing - A valued tool for assessing adverse reactions to anaesthetic agents in patients allergic to multiple drugs: A case report from a secondary-level hospital.
J Perioper Pract
November 2024
Department of Immunology & Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, India.
Patients with allergy to multiple drugs who have experienced anaphylaxis multiple times present a significant challenge in perioperative management. This report presents a 27-year-old female patient diagnosed with cholelithiasis scheduled for cholecystectomy. The patient has a history of adverse reaction to multiple drugs, including Amoxicillin/Clavulanic acid, Cefpodoxime, Levofloxacin and two additional drugs (one analgesic and the other multivitamin) each resulting in symptoms suggestive of anaphylaxis on separate occasions.
View Article and Find Full Text PDFStability of Antibiotics for Use in the Testing of Immediate Drug Allergy Reactions.
J Allergy Clin Immunol Pract
November 2024
Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
Article Synopsis
- Limited information exists about the stability of penicillin-based antibiotics for skin testing, prompting a study on 16 parenteral antibiotics to evaluate their physicochemical stability and provide guidelines for clinicians.
- Most antibiotics showed good stability for 2 to 7 days, with amoxicillin/clavulanic acid being a notable exception, dropping below acceptable levels by day 2.
- The research included specific tests for chemical and physical stability, revealing that while many antibiotics maintained acceptable performance, some experienced significant color changes and pH drops over time.
Clinical Relevance of Specific IgE in Penicillin Allergy Investigation.
Int Arch Allergy Immunol
October 2024
Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.
Introduction: Patients with immediate type allergic reactions to penicillins are at risk of anaphylaxis on reexposure. Diagnostic gold standard is drug provocation test (DPT) if allergy is not diagnosed by other means, such as skin testing or in vitro testing with measurement of specific IgE. Specific IgE testing carries low risk for the patient and blood sampling can be performed in primary care, but it is reported to have low sensitivity.
View Article and Find Full Text PDFSerum metabolomics analysis reveals potential biomarkers of penicillins-induced fatal anaphylactic shock in rats.
Sci Rep
October 2024
School of Forensic Medicine, Shanxi Medical University, Taiyuan, 030001, P. R. China.
Article Synopsis
- Immunoglobulin E (IgE)-mediated allergic reactions to penicillin antibiotics can be severe and potentially deadly, making their diagnosis after anaphylactic deaths challenging due to non-specific indicators.
- This study utilized a liquid chromatography-mass spectrometry (LC-MS) untargeted metabolomics approach to identify forensic biomarkers related to fatal anaphylactic shock caused by four types of penicillin antibiotics.
- The research identified 24 distinct metabolites linked to allergic reactions, highlighting six common ones that formed a strong biomarker model for diagnosing penicillin-induced anaphylaxis, suggesting that metabolomic profiling can enhance post-mortem investigations.
Preadmission Penicillin Allergy Evaluation Before Hematopoietic Stem Cell Transplantation Optimizes Febrile Neutropenia Treatment and Inpatient Resource Utilization.
Transplant Cell Ther
November 2024
Division of Allergy & Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts.
Febrile neutropenia is a common complication of conditioning chemotherapy for hematopoietic stem cell transplant (HSCT), but a major barrier for optimal treatment of febrile neutropenia is historical penicillin allergies. Our group recently published a development of a clinical pipeline for delabeling penicillin allergies in adult patients planned to undergo hematopoietic stem cell transplant (HSCT). In this retrospective cohort study, we followed patients to evaluate their outcomes during inpatient admission for HSCT.
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