A importância das provas epicutâneas de contacto no diagnóstico diferencial de reações a medicamentos

Travassos, Ana Rita; Pacheco, David; Antunes, Joana; Silva, Raquel; Soares‐de‐Almeida, Luís; Filipe, Paulo

doi:10.1590/s0365-05962011000700004

Cited by 3 publications

(1 citation statement)

References 8 publications

(12 reference statements)

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“…The antibiotic in the vehicle and vehicle control are placed in patch wells and attached to the skin, removed at 48 h, with additional readings at 96 h and 7 days [52]. The sensitivity of patch testing is variable and most reactions are limited to the site of application with systemic reactions rarely noted [52]. The sensitivity of patch testing is highest for AGEP and DRESS, greater than fixed drug eruption (FDE; at the site of the reaction), and lowest for SJS/ TEN.…”

Section: Testing For Type IV Reactions To Antibioticsmentioning

confidence: 99%

Antimicrobial stewardshipʼs new weapon? A review of antibiotic allergy and pathways to ‘de-labeling’

Trubiano

Phillips

2013

Current Opinion in Infectious Diseases

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Purpose of review The continued emergence of multiresistant pathogens and widespread antimicrobial use has led to a greater emphasis on antimicrobial stewardship programs. Concurrently, an increased awareness of the rising number of antibiotic allergy labels and impact on antimicrobial use has surfaced. The integration of antibiotic allergy de-labeling and antimicrobial stewardship programs may be a pathway worthy of further focus and investigation. Recent findings Recent literature has evaluated the efficacy of antibiotic allergy management (historical de-labeling, in-vitro testing, skin prick testing, intradermal testing, and oral challenges) and impact of antibiotic allergy labels on patient outcome. The importance of true and perceived antibiotic allergy cross-reactivity in the setting of β-lactam allergies has been highlighted. The impact of dedicated antibiotic allergy de-labeling clinics, inpatient antibiotic allergy testing, and integrated antimicrobial stewardship programs has been recently appraised. Summary More recent literature supports that appropriate antibiotic allergy in-vitro and in-vivo testing and subsequent antibiotic allergy de-labeling, particularly in regard to β-lactams, can decrease broad-spectrum antibiotic use, costs, patient length of stay, and mortality. Integration of antibiotic allergy management into the decision support systems of inpatient and outpatient antimicrobial stewardship programs represents an important opportunity to further improve measured outcomes from antibiotic utilization.

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Section: Testing For Type IV Reactions To Antibioticsmentioning

confidence: 99%

Antimicrobial stewardshipʼs new weapon? A review of antibiotic allergy and pathways to ‘de-labeling’

Trubiano

Phillips

2013

Current Opinion in Infectious Diseases

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An update on pediatric cutaneous drug eruptions

Song

Sidbury

2014

Clinics in Dermatology

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Alergia a Fármacos Com Manifestações Cutâneas - Abordagem Diagnóstica

Antunes

Brás

Prates

et al. 2013

SPDV

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As reacções adversas a fármacos (RAF) representam um problema frequente na prática clínica. A alergia a fármacos resulta de mecanismos de hipersensibilidade imunológica e representa 6-10% do total de RAF. Clinica- mente, as reacções alérgicas a fármacos podem ser classificadas como imediatas (tipo I) ou não-imediatas (com manifestações clínicas diversas e associadas sobretudo a reacções de tipo IV). Neste artigo são abordados aspectos gerais, nomeadamente os mecanismos imunopatogénicos implicados na alergia a fármacos e reactividade cruzada mas também as manifestações cutâneas mais relevantes, nomeadamente exantemas máculo-papulares, eritema fixo a fármacos (EFF), pustulose exantemática aguda generalizada (PEAG), síndrome de hipersensibilidade a fármacos (DRESS – drug rash with eosinophilia and systemic symptoms), síndrome de Stevens-Johnson/necrólise epidérmica tóxica (SSJ/NET). O papel dos testes cutâneos (epicutâneos ou intradérmicos de leitura tardia) na abordagem de reacções não-imediatas é também revisto. Os beta-lactâmicos (BL) são o grupo farmacológico mais frequentemente envolvido em reacções de hipersensibilidade imunológica e que mais dificuldades coloca na prática clínica diária, nomeadamente devido aos riscos de reactividade cruzada, pelo que é analisado em maior detalhe ao longo da revisão. A indução de tolerância a fármacos poderá ser considerada em casos selecionados, sobretudo quando na ausência de alternativas terapêuticas igualmente eficazes ou seguras.PALAVRAS-CHAVE – Hipersensibilidade a fármacos; Beta-Lactâmicos; Reactividade cruzada; Testes cutâneos.

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A importância das provas epicutâneas de contacto no diagnóstico diferencial de reações a medicamentos

Cited by 3 publications

References 8 publications

Antimicrobial stewardshipʼs new weapon? A review of antibiotic allergy and pathways to ‘de-labeling’

Antimicrobial stewardshipʼs new weapon? A review of antibiotic allergy and pathways to ‘de-labeling’

An update on pediatric cutaneous drug eruptions

Alergia a Fármacos Com Manifestações Cutâneas - Abordagem Diagnóstica

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