Annals of internal medicine · 2007
Brief communication: tolerability of meropenem in patients with IgE-mediated hypersensitivity to penicillins.
Клиническое исследованиеСтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Romano Antonino, Viola Marinella, Guéant-Rodriguez Rosa-Maria, Gaeta Francesco, Valluzzi Rocco, Guéant Jean-Louis
Аннотация
BACKGROUND: Although clinicians avoid giving meropenem to patients with penicillin allergy because of potential cross-reactivity, the rate of cross-reactivity between penicillins and meropenem has not been prospectively determined.
OBJECTIVE: To assess the tolerability of meropenem in patients with documented penicillin allergy.
DESIGN: Prospective skin testing and antibiotic challenge.
SETTING: Allergy units of 2 Italian medical centers.
PATIENTS: 104 consecutive participants with immediate hypersensitivity reactions to penicillins and positive skin test results to at least 1 penicillin reagent.
MEASUREMENTS: Skin tests to meropenem and, if results were negative, challenges with escalating doses of meropenem.
RESULTS: One participant (0.9% [95% CI, 0.02% to 5.2%]) had a positive intradermal test result to meropenem. The remaining 103 participants with negative skin test results to meropenem tolerated escalating dose challenges.
LIMITATION: Challenges were not followed by therapeutic courses.
CONCLUSIONS: These data indicate a low rate of cross-reactivity between penicillins and meropenem. Therefore, the practice of avoiding meropenem therapy in penicillin-allergic patients should be reconsidered. In patients who especially require meropenem treatment, the authors recommend pretreatment skin tests because negative results indicate tolerability.
OBJECTIVE: To assess the tolerability of meropenem in patients with documented penicillin allergy.
DESIGN: Prospective skin testing and antibiotic challenge.
SETTING: Allergy units of 2 Italian medical centers.
PATIENTS: 104 consecutive participants with immediate hypersensitivity reactions to penicillins and positive skin test results to at least 1 penicillin reagent.
MEASUREMENTS: Skin tests to meropenem and, if results were negative, challenges with escalating doses of meropenem.
RESULTS: One participant (0.9% [95% CI, 0.02% to 5.2%]) had a positive intradermal test result to meropenem. The remaining 103 participants with negative skin test results to meropenem tolerated escalating dose challenges.
LIMITATION: Challenges were not followed by therapeutic courses.
CONCLUSIONS: These data indicate a low rate of cross-reactivity between penicillins and meropenem. Therefore, the practice of avoiding meropenem therapy in penicillin-allergic patients should be reconsidered. In patients who especially require meropenem treatment, the authors recommend pretreatment skin tests because negative results indicate tolerability.