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.
Section of Allergy and Immunology, Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Introduction: Penicillins and other beta-lactam antibiotics are used in greater than one-third of pregnant women as treatment for Group B Streptococcus colonization and prophylaxis for Caesarean sections. Penicillin allergy labels have been associated with increased morbidity in the pregnant population, and penicillin allergy evaluation during pregnancy is now recognized as safe and effective. Yet, demographic characteristics associated with having a penicillin allergy label during pregnancy have not been studied.
() presents significant clinical challenges. This study evaluated the synergistic effects of a β-lactam and β-lactamase inhibitor combination against and explored the underlying mechanisms. Synergy was assessed through MIC tests and time-kill studies, and binding affinities of nine β-lactams and BLIs to eight target receptors (L,D-transpeptidases [LDT] 1-5, D,D-carboxypeptidase, penicillin-binding protein [PBP] B, and PBP-lipo) were assessed using mass spectrometry and kinetic studies.
Department of Internal Medicine, Allergology and Clinical Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland.
The decision whether to de-label patient with suspected BL hypersensitivity is based on risk stratification. The aim of this study was to prepare a characteristic of diagnostic risk groups and to create a model enabling the identification of the low-risk diagnostic group. We analyzed the medical records of patients hospitalized due to suspected hypersensitivity to BL antibiotics.
Clostridioides difficile infection (CDI) is the most common nosocomial infection in the US. CDI has become a growing concern due to C. difficile's resistance to several antibiotics, including cephalosporins.
Symmetric drug-related intertriginous and flexural exanthem (SDRIFE) is a rare delayed-type hypersensitivity reaction that is considered a variant of systemic allergic contact dermatitis. It is typically triggered by drugs such as beta-lactam antibiotics or antihypertensives. The reaction presents as erythema with flexural prominence.
