Management of patients with a history of beta-lactam intolerance

Abstract

Penicillins are one of the most commonly prescribed groups of antimicrobials. Up to 8-25% of the general population has a history of allergy to penicillins. However, hyperdiagnostics of penicillin allergy occurs in 90 to 95% of cases, mostly before the age of 3 years, and is associated with an incorrect interpretation of the symptoms of viral infections. The real frequency of life-threatening conditions associated with beta-lactam allergy does not exceed 0.04% of cases of penicillin administration. Hyperdiagnostics of beta-lactam allergy results in a decrease in the quality of medical care, as well as additional costs for the healthcare system. Careful anamnesis, identifying of patients with low risk of allergic reactions to penicillins and oral and skin tests allow to rule out or to establish allergy to beta-lactam antimicrobials and to choose the optimum antimicrobial therapy.