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Anti-Bacterial Agents / adverse effects

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Evaluation of Suspected Antibiotic Allergies

Author/s: 
Ruchi Singla, Megan C Elios, Andrew M Davis

Antibiotic-associated adverse drug reactions are often mild (eg, nausea or diarrhea) and typically occur 1 to 6 hours after drug exposure. IgE-mediated reactions cause urticaria, angioedema, bronchospasm, or, in severe cases, anaphylaxis. Cell-mediated delayed hypersensitivity can occur over days to weeks, most commonly as benign cutaneous morbilliform eruptions, although more severe manifestations, such as Stevens-Johnson syndrome, may occur.

The guideline provides evidence-based recommendations for evaluating possible drug allergy in nonsteroidal anti-inflammatory drugs, chemotherapies, immune checkpoint inhibitors, biologic agents, and excipients (inactive substances formulated with pharmaceuticals). This JAMA Clinical Guidelines Synopsis focuses on practice recommendations for antibiotic allergy evaluation.

Keywords 
Anaphylaxis antibiotics antibiotic allergies

Penicillin allergy delabelling of patients at risk of sexually transmitted infections in primary care

Author/s: 
Wittmer, R., Vincent-Boulay, O., Barrios, J. L.

KEY POINTS
Most patients who report a penicillin allergy do not have a serious allergy.

Penicillin allergy delabelling enables patients to receive penicillin and β-lactam antibiotics when indicated.

A simple algorithm allows for stratification of allergy risk for patients.

Patients at low risk of a serious allergic reaction can undergo an oral penicillin challenge in sexual health clinics and other primary care settings.

Keywords 
Penicillins Anti-Bacterial Agents primary health care sexually transmitted diseases hypersensitivity
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