Immediate and Delayed Hypersensitivity Reactions to Beta-Lactam Antibiotics

Clinical Reviews in Allergy - Tập 62 - Trang 449-462 - 2021
Ellen Minaldi1, Elizabeth J Phillips2, Allison Norton3
1Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA
2Department of Medicine, Vanderbilt University Medical Center, Nashville, USA.
3Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA

Tóm tắt

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.

Tài liệu tham khảo

Sousa-Pinto B, Fonseca JA, Gomes ER (2017) Frequency of self-reported drug allergy: a systemic review and meta-analysis with meta-regression. Ann Allergy Asthma Immunol 119:361–73e2

Torres MJ, Adkinson NF Jr, Caubet JC et al (2019) Controversies in drug allergy: beta-lactam hypersensitivity testing [published correction appears in]. J Allergy Clin Immunol Pract 7(1):40–45

Gell P, Coombs R, Lachmann P (1968) Classification of allergic reactions for clinical hypersensitivity disease. In: Gell PGH, Coombs RPA (eds) Clinical Aspects of Immunology. Blackwell Scientific Publications, Oxford, United Kingdom, pp 575–579

Vyles D, Antoon JW, Norton A, Stone CA Jr, Trubiano J, Radowicz A, Phillips EJ (2020) Children with reported penicillin allergy: public health impact and safety of delabeling. Ann Allergy Asthma Immunol 124(6):558–565

JACI In Practice. Delayed hypersensitivity drug allergy testing [video]. YouTube. Published 30 Sep 2020. https://www.youtube.com/channel/UC8HeaVXcaOXzYv_cp-vsRtA. Accessed 18 Feb 2021

JACI In Practice. Immediate hypersensitivity drug allergy testing [video]. YouTube. Published 30 Sep 2020. https://www.youtube.com/watch?v=R9yWxDY3YCA. Accessed 18 Feb 2021

Fonacier L (2015) A practical guide to patch testing. J Allergy Clin Immunol Pract 3(5):669–75. https://doi.org/10.1016/j.jaip.2015.05.001. Epub 6 Jun 2015

Labrosse R, Paradis L, Lacombe-Barrios J, Samaan K, Graham F, Paradis J, Begin P, Des Roches A (2018) Efficacy and safety of 5-day challenge for the evaluation of nonsevere amoxicillin allergy in children. J Allergy Clin Immunol Pract 6(5):1673–1680

Lehloenya RJ, Peter JG, Copascu A, Trubiano JA, Phillips EJ (2020) Delabeling delayed drug hypersensitivity: how far can you safely go? J Allergy Clin Immunol Pract 8(9):2878-2895.e6. https://doi.org/10.1016/j.jaip.2020.07.005.Erratum.In:JAllergyClinImmunolPract.2021Jan;9(1):603

Copaescu A, Rose M, Mouhtouris E, Chua KY, Holmes NE, Phillips EJ, Trubiano JA. Delayed hypersensitivity associated with amoxicillin-clavulanate. Allergy. https://doi.org/10.1111/all.14359. Epub ahead of print. PMID: 32390163.

Scherer K, Brockow K, Aberer W et al (2013) European Network on Drug Allergy and the EAACI Drug Allery Interest Group. Desensitization in delayed drug hypersensitivity reactions – an EAACI position paper of the Drug Allergy Interest Group. Allergy 68(7):844–852

Pederson-Bjergaard J (1967) Cephalothin in the treatment of penicillin sensitive patients. Acta Allergol 22:299–306. III

Lam PW, Tarighi P, Elligsen M, Gunaratne K, Nathens AB, Tarshis J, Leis JA (2020) Self-reported beta-lactam allergy and the risk of surgical site infection: a retrospective cohort study. Infect Control Hosp Epidemiol 41(4):438–443. https://doi.org/10.1017/ice.2019.374 (Epub 23 Jan 2020 PMID: 31969205)

Derrick MI, Williams KB, Shade LMP, Phillips EJ (2018) A survey of drug allergy training opportunities in the United States. J Allergy Clin Immunol Pract 6(1):302–304. https://doi.org/10.1016/j.jaip.2017.08.003. Epub 22 Sep 2017