Practical management of antibiotic allergy in adults

McLean‐Tooke, Andrew; Aldridge, Catherine; Stroud, Catherine; Spickett, Gavin P

doi:10.1136/jcp.2010.077289

Cited by 10 publications

(8 citation statements)

References 71 publications

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“…Classical desensitization protocols are designed to treat type 1 (IgE-mediated) mast cell reactions [31]. The typical request for drug desensitization may better be described as induction of drug tolerance without an adverse reaction [32].…”

Section: Principles Of Desensitizationmentioning

confidence: 99%

Antibiotic Hypersensitivity Reactions and Approaches to Desensitization

Legendre¹,

Muzny

Marshall³

et al. 2013

Clinical Infectious Diseases

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Before initiating antibiotic therapy, drug hypersensitivity is an important consideration, and a common strategy is to avoid giving patients medications when a high likelihood of severe reactions exists. With an increase in antibiotic resistance and a decrease in novel antibiotics, there is greater pressure to consider antibiotics in patients with a history of adverse reactions. The major concerns include IgE-mediated, or type I, reactions, anaphylaxis, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Some antibiotics with similar characteristics, such as cephalosporins and penicillins, may be given safely to patients with a certain allergy profile. There is still greater concern when considering antibiotics for patients with reported allergy. Desensitization is a strategy to safely induce drug tolerance to a specific drug to limit the possibility of a type I reaction.

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Section: Principles Of Desensitizationmentioning

confidence: 99%

Antibiotic Hypersensitivity Reactions and Approaches to Desensitization

Legendre¹,

Muzny

Marshall³

et al. 2013

Clinical Infectious Diseases

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“…3. Algorithms of use of cephalosporins in patients with reported penicillin allergy [81] If it is impossible to replace the antibiotic, which probably is the cause of the allergic reaction, a challenge is required [30,80,82]. Contraindications to challenge are Stevens-Johnson or Lyell's syndrome at an earlier age.…”

Section: Picmentioning

confidence: 99%

“…equal to the therapeutic dose, for the next administration in the event of a negative result. If the patient experienced severe anaphylactic reactions within the latest year, a challenge starts with 1/1,000 of the singular therapeutic dose [30,82]. Despite a rather detailed description of the challenge technique by foreign authors, unfortunately, it is not possible to use it routinely in Russian clinical practice, as there are no legally binding Russian documents (i.e.…”

Section: Picmentioning

confidence: 99%

Allergy to Antibiotics in Children: Who Is to Blame and What to Do?

Andreeva¹,

Стецюк²

2013

Pediatr. farmakol.

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“…Incorrect penicillin allergy records are common, as side effects and symptoms of illness can be mistaken for allergic reaction symptoms (1). About 6% of the UK general practice population has a record of a penicillin allergy but fewer than 10% of these patients are likely to be truly allergic (2).…”

Section: Introductionmentioning

confidence: 99%

Developing a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice

Santillo¹,

Wanat²,

Davoudianfar³

et al. 2019

Preprint

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Background: To develop a behavioural intervention package to support clinicians and patients to identify and amend incorrect penicillin allergy records in English general practice. The intervention aimed to: 1) support general practice clinicians to refer patients for penicillin allergy testing (PAT), 2) support patients to attend for PAT and 3) support clinicians and patients to prescribe or consume penicillin, when indicated, following a negative PAT result.Methods: Theory-based, evidence-based and person-based approaches were utilised in the intervention development. We used evidence from a rapid review, two qualitative studies, one with patients and one with general practice clinicians, and expert consultation with the clinical research team in order to identify the intervention guiding principles and develop an intervention plan. Barriers and facilitators to the target behaviours were mapped to behaviour change theory in order to describe the proposed mechanisms of change. In the final stage, think-aloud interviews and consultations with the clinical research team were conducted to optimise intervention materials.Results: The collated evidence showed that the key barriers to referral of patients by clinicians were limited experience of referral and limited knowledge of referral criteria and PAT. Barriers for patients attending PAT were lack of knowledge of the benefits of testing and lack of motivation to get tested. Intervention materials were designed and developed to address these barriers. Conclusions: We present a novel behavioural intervention package designed to address the multiple barriers to uptake of PAT in general practice by clinicians and patients. The intervention development details how behaviour change techniques have been incorporated to hypothesise how the intervention is likely to work to help amend incorrect penicillin allergy records. The intervention will go on to be tested in a feasibility trial and randomised controlled trial in England.

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Practical management of antibiotic allergy in adults

Cited by 10 publications

References 71 publications

Antibiotic Hypersensitivity Reactions and Approaches to Desensitization

Antibiotic Hypersensitivity Reactions and Approaches to Desensitization

Allergy to Antibiotics in Children: Who Is to Blame and What to Do?

Developing a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice

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