This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
• Identify criteria for identifying penicillin allergy.
• Identify alternatives to penicillin antibiotics
• Identify penicillin testing options
4/23/2019
2
https://www.penallergytest.com/implementation-2/
PenAllergy Testing
“I had a penicillin allergic reaction when I was a child”
Children whom receive amoxicillin or ampillicin and have Epstein-Barr virus infection can develop a non-allergic, non-pruritic rash that can appear similar to an allergic reaction
since there are other antibiotic classes available?
Shenoy E, Macy E, Rowe TA, Blumenthal KG. Evaluation and management of penicillin allergy.JAMA 2019; 32(2):188-199.
4/23/2019
5
Pongdee T, Li JT. Evaluation and Management of Penicillin Allergy. Mayo Clin Proc. 2018 Jan; 93 (1):101-107
Cross-Reactivity?
Shenoy E, Macy E, Rowe TA, Blumenthal KG. Evaluation and management of penicillin allergy. JAMA 2019; 32(2):188-199
4/23/2019
6
https://resistancemap.cddep.org/
4/23/2019
7
http://www.qualityforum.org/Publications/2016/05/Antibiotic_Stewardship_Playbook.aspx?utm_source=external&utm_medium=link&utm_term=ABX&utm_content=Playbook&utm_campaign=ABX –Quality Forum Web site
Penicillin Allergy Patient Outcomes
Shenoy E, Macy E, Rowe TA, Blumenthal KG. Evaluation and management of penicillin allergy. JAMA 2019; 32(2):188-199
Need to Obtain a Thorough Patient History
4/23/2019
8
Shenoy E, Macy E, Rowe TA, Blumenthal KG. Evaluation and management of penicillin allergy. JAMA 2019; 32(2):188-199
Identifying if Truly Penicillin Allergic
4/23/2019
9
Shenoy E, Macy E, Rowe TA, Blumenthal KG. Evaluation and management of penicillin allergy. JAMA 2019; 32(2):188-199
4/23/2019
10
Shenoy E, Macy E, Rowe TA, Blumenthal KG. Evaluation and management of penicillin allergy. JAMA 2019; 32(2):188-199
Amoxicillin Allergy Testing with Skin Test
4/23/2019
11
Shenoy E, Macy E, Rowe TA, Blumenthal KG. Evaluation and management of penicillin allergy. JAMA 2019; 32(2):188-199
Shenoy E, Macy E, Rowe TA, Blumenthal KG. Evaluation and management of penicillin allergy. JAMA 2019; 32(2):188-199
4/23/2019
19
Desensitization Example (Patient specific)
Patient Handouts
4/23/2019
20
4/23/2019
21
?
I am Allergic to Penicillin
References• Joint Task Force on Practice Parameters representing the American Academy of Allergy, Asthma and
Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273.
• Gonzalez-Estrada A, Radojicic C. Penicillin allergy: a practical guide for clinicians. Cleve Clin J Med. 2015 May;82(5):295-300.
• Herrier RN, Apgar DA, Boyce RW, Foster SL. Patient assessment in pharmacy. New York: McGraw-Hill; 2015 [cited 2015 Aug 14]. Available from: http://accesspharmacy.mhmedical.com/content.aspx?bookid=1074&Sectionid=62364288External.
• Bernstein JA. Update on angioedema: evaluation, diagnosis, and treatment. Allergy Asthma Proc 2011; 32(6):408-412.
• Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A et al. Second symposium on the definition and management of anaphylaxis: summary report–second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. Ann Emerg Med. 2006; 47:373-380.
• Blumenthal KG, Shenoy ES, Hurwitz S, Varughese CA, Hooper DC, Banerji A. Effect of a drug allergy educational program and antibiotic prescribing guideline on inpatient clinical providers’ antibiotic prescribing knowledge. J Allergy Clin Immunol. 2014;2(4):407-412.
• Macy E, Ngor E. Recommendations for the management of beta-lactam intolerance. Clinical Rev Allerg Immunol. 2014; 47:46-55.
• Pichichero, ME. A review of evidence supporting the American Academy of Pediatrics recommendation for prescribing cephalosporin antibiotics for penicillin-allergic patients. Pediatrics. 2005 Apr; 115(4):1048-1057.
• Centers for Disease Control and Prevention [Internet]. About Epstein-Barr Virus (EBV) [cited 2015 Aug 17]. Available from: http://www.cdc.gov/epstein-barr/about-ebv.html.
• CDC Evaluation and diagnosis of penicillin allergy for healthcare professionals. https://www.cdc.gov/antibiotic-use/community/for-hcp/Penicillin-Allergy.html
• Pongdee T, Li JT. Evaluation and Management of Penicillin Allergy. Mayo Clin Proc. 2018 Jan; 93 (1):101-107 • Shenoy E, Macy E, Rowe TA, Blumenthal KG. Evaluation and management of penicillin allergy.JAMA 2019;