Immediate and Delayed Hypersensitivity Reactions to Beta-Lactam Antibiotics.
Cross-reactivity
HLA
Ingestion challenge
Patch test
Penicillin
Rash
SCAR
Skin test
T-cell
Journal
Clinical reviews in allergy & immunology
ISSN: 1559-0267
Titre abrégé: Clin Rev Allergy Immunol
Pays: United States
ID NLM: 9504368
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
accepted:
10
09
2021
pubmed:
13
11
2021
medline:
3
6
2022
entrez:
12
11
2021
Statut:
ppublish
Résumé
Beta-lactam antibiotics are the most commonly reported drug allergy in adults and children. More than 95% of those with reported allergy labels to beta lactams are not confirmed when subjected to allergy testing. Beta lactam antibiotics are associated with a wide spectrum of immediate and delayed drug hypersensitivity reactions. The latency period to symptoms and clinical presentation aids in the causality assessment. Risk stratification based on diagnosis and timing then allows for appropriate management and evaluation. Skin prick testing, intradermal testing and oral challenge are well established for evaluation of immediate reactions. Delayed intradermal testing, patch testing and oral challenge can also be considered for evaluation of mild to moderate delayed reactions. Cross-reactivity between beta-lactams appears to be driven most commonly by a shared R1 side-chain. Standardized algorithms, protocols and pathways are needed for widespread implementation of a pragmatic and effective approach to patients reporting beta lactam allergy.
Identifiants
pubmed: 34767158
doi: 10.1007/s12016-021-08903-z
pii: 10.1007/s12016-021-08903-z
doi:
Substances chimiques
Anti-Bacterial Agents
0
beta-Lactams
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
449-462Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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