Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project
Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratificat...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Querbach, Christiane [verfasserIn] Biedermann, Tilo [verfasserIn] Busch, Dirk H. [verfasserIn] Eisenhart-Rothe, Rüdiger [verfasserIn] Feihl, Susanne [verfasserIn] Filser, Christiane [verfasserIn] Gebhardt, Friedemann [verfasserIn] Heim, Markus [verfasserIn] Renz, Helmut [verfasserIn] Rothe, Kathrin [verfasserIn] Spinner, Christoph D. [verfasserIn] Starzner, Melanie [verfasserIn] Suren, Christian [verfasserIn] Trojan, Monika [verfasserIn] Brockow, Knut [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2020 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Allergo journal international - München : Urban & Vogel, 2014, 29(2020), 6 vom: 27. Aug., Seite 174-180 |
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| Übergeordnetes Werk: |
volume:29 ; year:2020 ; number:6 ; day:27 ; month:08 ; pages:174-180 |
| Links: |
|---|
| DOI / URN: |
10.1007/s40629-020-00135-5 |
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| Katalog-ID: |
SPR040964809 |
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| 245 | 1 | 0 | |a Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project |
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| 520 | |a Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratification in the case of a history of suspected BLA allergy. Methods Using the available stratification programs and taking current guidelines into account, an algorithm for risk stratification, including recommendations on the use of antibiotics in cases of compellingly indicated BLA despite suspected BLA allergy, was formulated by the authors for their maximum care university hospital. Results The hospital is in great need of recommendations on how to deal with BLA allergies. Patient-reported information in the history forms the basis for classifying the reactions into four risk categories: (1) BLA allergy excluded, (2) benign delayed reaction, (3) immediate reaction, and (4) severe cutaneous and extracutaneous drug reaction. Recommendations strictly depend on this classification and range from use of full-dose BLA or use of BLA under certain conditions (e.g., two-stage dose escalation, non-cross-reactive BLA only) to prohibiting all BLA and the use of alternative non-BLA. In case of suspected immediate or delayed allergic reactions, there is an additional recommendation regarding subsequent allergy testing during a symptom-free interval. Conclusion Triage of patients with suspected BLA is urgently required. While allergy testing, including provocation testing, represents the most reliable solution, this is not feasible in all patients due to the high prevalence of BLA allergies. The risk stratification algorithm developed for the authors’ hospital represents a tool suitable to making a contribution to rational antibiotic therapy. | ||
| 650 | 4 | |a Beta-lactam antibiotics |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Penicillin |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Risk stratification |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Checklist |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Algorithms |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Acute treatment |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Biedermann, Tilo |e verfasserin |4 aut | |
| 700 | 1 | |a Busch, Dirk H. |e verfasserin |4 aut | |
| 700 | 1 | |a Eisenhart-Rothe, Rüdiger |e verfasserin |4 aut | |
| 700 | 1 | |a Feihl, Susanne |e verfasserin |4 aut | |
| 700 | 1 | |a Filser, Christiane |e verfasserin |4 aut | |
| 700 | 1 | |a Gebhardt, Friedemann |e verfasserin |4 aut | |
| 700 | 1 | |a Heim, Markus |e verfasserin |4 aut | |
| 700 | 1 | |a Renz, Helmut |e verfasserin |4 aut | |
| 700 | 1 | |a Rothe, Kathrin |e verfasserin |4 aut | |
| 700 | 1 | |a Spinner, Christoph D. |e verfasserin |4 aut | |
| 700 | 1 | |a Starzner, Melanie |e verfasserin |4 aut | |
| 700 | 1 | |a Suren, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Trojan, Monika |e verfasserin |4 aut | |
| 700 | 1 | |a Brockow, Knut |e verfasserin |4 aut | |
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10.1007/s40629-020-00135-5 doi (DE-627)SPR040964809 (SPR)s40629-020-00135-5-e DE-627 ger DE-627 rakwb eng 610 ASE Querbach, Christiane verfasserin aut Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratification in the case of a history of suspected BLA allergy. Methods Using the available stratification programs and taking current guidelines into account, an algorithm for risk stratification, including recommendations on the use of antibiotics in cases of compellingly indicated BLA despite suspected BLA allergy, was formulated by the authors for their maximum care university hospital. Results The hospital is in great need of recommendations on how to deal with BLA allergies. Patient-reported information in the history forms the basis for classifying the reactions into four risk categories: (1) BLA allergy excluded, (2) benign delayed reaction, (3) immediate reaction, and (4) severe cutaneous and extracutaneous drug reaction. Recommendations strictly depend on this classification and range from use of full-dose BLA or use of BLA under certain conditions (e.g., two-stage dose escalation, non-cross-reactive BLA only) to prohibiting all BLA and the use of alternative non-BLA. In case of suspected immediate or delayed allergic reactions, there is an additional recommendation regarding subsequent allergy testing during a symptom-free interval. Conclusion Triage of patients with suspected BLA is urgently required. While allergy testing, including provocation testing, represents the most reliable solution, this is not feasible in all patients due to the high prevalence of BLA allergies. The risk stratification algorithm developed for the authors’ hospital represents a tool suitable to making a contribution to rational antibiotic therapy. Beta-lactam antibiotics (dpeaa)DE-He213 Penicillin (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Checklist (dpeaa)DE-He213 Algorithms (dpeaa)DE-He213 Acute treatment (dpeaa)DE-He213 Biedermann, Tilo verfasserin aut Busch, Dirk H. verfasserin aut Eisenhart-Rothe, Rüdiger verfasserin aut Feihl, Susanne verfasserin aut Filser, Christiane verfasserin aut Gebhardt, Friedemann verfasserin aut Heim, Markus verfasserin aut Renz, Helmut verfasserin aut Rothe, Kathrin verfasserin aut Spinner, Christoph D. verfasserin aut Starzner, Melanie verfasserin aut Suren, Christian verfasserin aut Trojan, Monika verfasserin aut Brockow, Knut verfasserin aut Enthalten in Allergo journal international München : Urban & Vogel, 2014 29(2020), 6 vom: 27. Aug., Seite 174-180 (DE-627)779923413 (DE-600)2759765-9 2197-0378 nnns volume:29 year:2020 number:6 day:27 month:08 pages:174-180 https://dx.doi.org/10.1007/s40629-020-00135-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 29 2020 6 27 08 174-180 |
| spelling |
10.1007/s40629-020-00135-5 doi (DE-627)SPR040964809 (SPR)s40629-020-00135-5-e DE-627 ger DE-627 rakwb eng 610 ASE Querbach, Christiane verfasserin aut Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratification in the case of a history of suspected BLA allergy. Methods Using the available stratification programs and taking current guidelines into account, an algorithm for risk stratification, including recommendations on the use of antibiotics in cases of compellingly indicated BLA despite suspected BLA allergy, was formulated by the authors for their maximum care university hospital. Results The hospital is in great need of recommendations on how to deal with BLA allergies. Patient-reported information in the history forms the basis for classifying the reactions into four risk categories: (1) BLA allergy excluded, (2) benign delayed reaction, (3) immediate reaction, and (4) severe cutaneous and extracutaneous drug reaction. Recommendations strictly depend on this classification and range from use of full-dose BLA or use of BLA under certain conditions (e.g., two-stage dose escalation, non-cross-reactive BLA only) to prohibiting all BLA and the use of alternative non-BLA. In case of suspected immediate or delayed allergic reactions, there is an additional recommendation regarding subsequent allergy testing during a symptom-free interval. Conclusion Triage of patients with suspected BLA is urgently required. While allergy testing, including provocation testing, represents the most reliable solution, this is not feasible in all patients due to the high prevalence of BLA allergies. The risk stratification algorithm developed for the authors’ hospital represents a tool suitable to making a contribution to rational antibiotic therapy. Beta-lactam antibiotics (dpeaa)DE-He213 Penicillin (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Checklist (dpeaa)DE-He213 Algorithms (dpeaa)DE-He213 Acute treatment (dpeaa)DE-He213 Biedermann, Tilo verfasserin aut Busch, Dirk H. verfasserin aut Eisenhart-Rothe, Rüdiger verfasserin aut Feihl, Susanne verfasserin aut Filser, Christiane verfasserin aut Gebhardt, Friedemann verfasserin aut Heim, Markus verfasserin aut Renz, Helmut verfasserin aut Rothe, Kathrin verfasserin aut Spinner, Christoph D. verfasserin aut Starzner, Melanie verfasserin aut Suren, Christian verfasserin aut Trojan, Monika verfasserin aut Brockow, Knut verfasserin aut Enthalten in Allergo journal international München : Urban & Vogel, 2014 29(2020), 6 vom: 27. Aug., Seite 174-180 (DE-627)779923413 (DE-600)2759765-9 2197-0378 nnns volume:29 year:2020 number:6 day:27 month:08 pages:174-180 https://dx.doi.org/10.1007/s40629-020-00135-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 29 2020 6 27 08 174-180 |
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10.1007/s40629-020-00135-5 doi (DE-627)SPR040964809 (SPR)s40629-020-00135-5-e DE-627 ger DE-627 rakwb eng 610 ASE Querbach, Christiane verfasserin aut Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratification in the case of a history of suspected BLA allergy. Methods Using the available stratification programs and taking current guidelines into account, an algorithm for risk stratification, including recommendations on the use of antibiotics in cases of compellingly indicated BLA despite suspected BLA allergy, was formulated by the authors for their maximum care university hospital. Results The hospital is in great need of recommendations on how to deal with BLA allergies. Patient-reported information in the history forms the basis for classifying the reactions into four risk categories: (1) BLA allergy excluded, (2) benign delayed reaction, (3) immediate reaction, and (4) severe cutaneous and extracutaneous drug reaction. Recommendations strictly depend on this classification and range from use of full-dose BLA or use of BLA under certain conditions (e.g., two-stage dose escalation, non-cross-reactive BLA only) to prohibiting all BLA and the use of alternative non-BLA. In case of suspected immediate or delayed allergic reactions, there is an additional recommendation regarding subsequent allergy testing during a symptom-free interval. Conclusion Triage of patients with suspected BLA is urgently required. While allergy testing, including provocation testing, represents the most reliable solution, this is not feasible in all patients due to the high prevalence of BLA allergies. The risk stratification algorithm developed for the authors’ hospital represents a tool suitable to making a contribution to rational antibiotic therapy. Beta-lactam antibiotics (dpeaa)DE-He213 Penicillin (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Checklist (dpeaa)DE-He213 Algorithms (dpeaa)DE-He213 Acute treatment (dpeaa)DE-He213 Biedermann, Tilo verfasserin aut Busch, Dirk H. verfasserin aut Eisenhart-Rothe, Rüdiger verfasserin aut Feihl, Susanne verfasserin aut Filser, Christiane verfasserin aut Gebhardt, Friedemann verfasserin aut Heim, Markus verfasserin aut Renz, Helmut verfasserin aut Rothe, Kathrin verfasserin aut Spinner, Christoph D. verfasserin aut Starzner, Melanie verfasserin aut Suren, Christian verfasserin aut Trojan, Monika verfasserin aut Brockow, Knut verfasserin aut Enthalten in Allergo journal international München : Urban & Vogel, 2014 29(2020), 6 vom: 27. Aug., Seite 174-180 (DE-627)779923413 (DE-600)2759765-9 2197-0378 nnns volume:29 year:2020 number:6 day:27 month:08 pages:174-180 https://dx.doi.org/10.1007/s40629-020-00135-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 29 2020 6 27 08 174-180 |
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10.1007/s40629-020-00135-5 doi (DE-627)SPR040964809 (SPR)s40629-020-00135-5-e DE-627 ger DE-627 rakwb eng 610 ASE Querbach, Christiane verfasserin aut Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratification in the case of a history of suspected BLA allergy. Methods Using the available stratification programs and taking current guidelines into account, an algorithm for risk stratification, including recommendations on the use of antibiotics in cases of compellingly indicated BLA despite suspected BLA allergy, was formulated by the authors for their maximum care university hospital. Results The hospital is in great need of recommendations on how to deal with BLA allergies. Patient-reported information in the history forms the basis for classifying the reactions into four risk categories: (1) BLA allergy excluded, (2) benign delayed reaction, (3) immediate reaction, and (4) severe cutaneous and extracutaneous drug reaction. Recommendations strictly depend on this classification and range from use of full-dose BLA or use of BLA under certain conditions (e.g., two-stage dose escalation, non-cross-reactive BLA only) to prohibiting all BLA and the use of alternative non-BLA. In case of suspected immediate or delayed allergic reactions, there is an additional recommendation regarding subsequent allergy testing during a symptom-free interval. Conclusion Triage of patients with suspected BLA is urgently required. While allergy testing, including provocation testing, represents the most reliable solution, this is not feasible in all patients due to the high prevalence of BLA allergies. The risk stratification algorithm developed for the authors’ hospital represents a tool suitable to making a contribution to rational antibiotic therapy. Beta-lactam antibiotics (dpeaa)DE-He213 Penicillin (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Checklist (dpeaa)DE-He213 Algorithms (dpeaa)DE-He213 Acute treatment (dpeaa)DE-He213 Biedermann, Tilo verfasserin aut Busch, Dirk H. verfasserin aut Eisenhart-Rothe, Rüdiger verfasserin aut Feihl, Susanne verfasserin aut Filser, Christiane verfasserin aut Gebhardt, Friedemann verfasserin aut Heim, Markus verfasserin aut Renz, Helmut verfasserin aut Rothe, Kathrin verfasserin aut Spinner, Christoph D. verfasserin aut Starzner, Melanie verfasserin aut Suren, Christian verfasserin aut Trojan, Monika verfasserin aut Brockow, Knut verfasserin aut Enthalten in Allergo journal international München : Urban & Vogel, 2014 29(2020), 6 vom: 27. Aug., Seite 174-180 (DE-627)779923413 (DE-600)2759765-9 2197-0378 nnns volume:29 year:2020 number:6 day:27 month:08 pages:174-180 https://dx.doi.org/10.1007/s40629-020-00135-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 29 2020 6 27 08 174-180 |
| allfieldsSound |
10.1007/s40629-020-00135-5 doi (DE-627)SPR040964809 (SPR)s40629-020-00135-5-e DE-627 ger DE-627 rakwb eng 610 ASE Querbach, Christiane verfasserin aut Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratification in the case of a history of suspected BLA allergy. Methods Using the available stratification programs and taking current guidelines into account, an algorithm for risk stratification, including recommendations on the use of antibiotics in cases of compellingly indicated BLA despite suspected BLA allergy, was formulated by the authors for their maximum care university hospital. Results The hospital is in great need of recommendations on how to deal with BLA allergies. Patient-reported information in the history forms the basis for classifying the reactions into four risk categories: (1) BLA allergy excluded, (2) benign delayed reaction, (3) immediate reaction, and (4) severe cutaneous and extracutaneous drug reaction. Recommendations strictly depend on this classification and range from use of full-dose BLA or use of BLA under certain conditions (e.g., two-stage dose escalation, non-cross-reactive BLA only) to prohibiting all BLA and the use of alternative non-BLA. In case of suspected immediate or delayed allergic reactions, there is an additional recommendation regarding subsequent allergy testing during a symptom-free interval. Conclusion Triage of patients with suspected BLA is urgently required. While allergy testing, including provocation testing, represents the most reliable solution, this is not feasible in all patients due to the high prevalence of BLA allergies. The risk stratification algorithm developed for the authors’ hospital represents a tool suitable to making a contribution to rational antibiotic therapy. Beta-lactam antibiotics (dpeaa)DE-He213 Penicillin (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Checklist (dpeaa)DE-He213 Algorithms (dpeaa)DE-He213 Acute treatment (dpeaa)DE-He213 Biedermann, Tilo verfasserin aut Busch, Dirk H. verfasserin aut Eisenhart-Rothe, Rüdiger verfasserin aut Feihl, Susanne verfasserin aut Filser, Christiane verfasserin aut Gebhardt, Friedemann verfasserin aut Heim, Markus verfasserin aut Renz, Helmut verfasserin aut Rothe, Kathrin verfasserin aut Spinner, Christoph D. verfasserin aut Starzner, Melanie verfasserin aut Suren, Christian verfasserin aut Trojan, Monika verfasserin aut Brockow, Knut verfasserin aut Enthalten in Allergo journal international München : Urban & Vogel, 2014 29(2020), 6 vom: 27. Aug., Seite 174-180 (DE-627)779923413 (DE-600)2759765-9 2197-0378 nnns volume:29 year:2020 number:6 day:27 month:08 pages:174-180 https://dx.doi.org/10.1007/s40629-020-00135-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 29 2020 6 27 08 174-180 |
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Enthalten in Allergo journal international 29(2020), 6 vom: 27. Aug., Seite 174-180 volume:29 year:2020 number:6 day:27 month:08 pages:174-180 |
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Enthalten in Allergo journal international 29(2020), 6 vom: 27. Aug., Seite 174-180 volume:29 year:2020 number:6 day:27 month:08 pages:174-180 |
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Beta-lactam antibiotics Penicillin Risk stratification Checklist Algorithms Acute treatment |
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Querbach, Christiane @@aut@@ Biedermann, Tilo @@aut@@ Busch, Dirk H. @@aut@@ Eisenhart-Rothe, Rüdiger @@aut@@ Feihl, Susanne @@aut@@ Filser, Christiane @@aut@@ Gebhardt, Friedemann @@aut@@ Heim, Markus @@aut@@ Renz, Helmut @@aut@@ Rothe, Kathrin @@aut@@ Spinner, Christoph D. @@aut@@ Starzner, Melanie @@aut@@ Suren, Christian @@aut@@ Trojan, Monika @@aut@@ Brockow, Knut @@aut@@ |
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2020-08-27T00:00:00Z |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR040964809</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519224653.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201007s2020 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s40629-020-00135-5</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR040964809</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s40629-020-00135-5-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">ASE</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Querbach, Christiane</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2020</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratification in the case of a history of suspected BLA allergy. Methods Using the available stratification programs and taking current guidelines into account, an algorithm for risk stratification, including recommendations on the use of antibiotics in cases of compellingly indicated BLA despite suspected BLA allergy, was formulated by the authors for their maximum care university hospital. Results The hospital is in great need of recommendations on how to deal with BLA allergies. Patient-reported information in the history forms the basis for classifying the reactions into four risk categories: (1) BLA allergy excluded, (2) benign delayed reaction, (3) immediate reaction, and (4) severe cutaneous and extracutaneous drug reaction. Recommendations strictly depend on this classification and range from use of full-dose BLA or use of BLA under certain conditions (e.g., two-stage dose escalation, non-cross-reactive BLA only) to prohibiting all BLA and the use of alternative non-BLA. In case of suspected immediate or delayed allergic reactions, there is an additional recommendation regarding subsequent allergy testing during a symptom-free interval. Conclusion Triage of patients with suspected BLA is urgently required. While allergy testing, including provocation testing, represents the most reliable solution, this is not feasible in all patients due to the high prevalence of BLA allergies. 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Querbach, Christiane |
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610 ASE Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project Beta-lactam antibiotics (dpeaa)DE-He213 Penicillin (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Checklist (dpeaa)DE-He213 Algorithms (dpeaa)DE-He213 Acute treatment (dpeaa)DE-He213 |
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Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project |
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Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project |
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Querbach, Christiane |
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Allergo journal international |
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600 - Technology |
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Querbach, Christiane Biedermann, Tilo Busch, Dirk H. Eisenhart-Rothe, Rüdiger Feihl, Susanne Filser, Christiane Gebhardt, Friedemann Heim, Markus Renz, Helmut Rothe, Kathrin Spinner, Christoph D. Starzner, Melanie Suren, Christian Trojan, Monika Brockow, Knut |
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Elektronische Aufsätze |
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Querbach, Christiane |
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10.1007/s40629-020-00135-5 |
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610 |
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verfasserin |
| title_sort |
suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project |
| title_auth |
Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project |
| abstract |
Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratification in the case of a history of suspected BLA allergy. Methods Using the available stratification programs and taking current guidelines into account, an algorithm for risk stratification, including recommendations on the use of antibiotics in cases of compellingly indicated BLA despite suspected BLA allergy, was formulated by the authors for their maximum care university hospital. Results The hospital is in great need of recommendations on how to deal with BLA allergies. Patient-reported information in the history forms the basis for classifying the reactions into four risk categories: (1) BLA allergy excluded, (2) benign delayed reaction, (3) immediate reaction, and (4) severe cutaneous and extracutaneous drug reaction. Recommendations strictly depend on this classification and range from use of full-dose BLA or use of BLA under certain conditions (e.g., two-stage dose escalation, non-cross-reactive BLA only) to prohibiting all BLA and the use of alternative non-BLA. In case of suspected immediate or delayed allergic reactions, there is an additional recommendation regarding subsequent allergy testing during a symptom-free interval. Conclusion Triage of patients with suspected BLA is urgently required. While allergy testing, including provocation testing, represents the most reliable solution, this is not feasible in all patients due to the high prevalence of BLA allergies. The risk stratification algorithm developed for the authors’ hospital represents a tool suitable to making a contribution to rational antibiotic therapy. |
| abstractGer |
Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratification in the case of a history of suspected BLA allergy. Methods Using the available stratification programs and taking current guidelines into account, an algorithm for risk stratification, including recommendations on the use of antibiotics in cases of compellingly indicated BLA despite suspected BLA allergy, was formulated by the authors for their maximum care university hospital. Results The hospital is in great need of recommendations on how to deal with BLA allergies. Patient-reported information in the history forms the basis for classifying the reactions into four risk categories: (1) BLA allergy excluded, (2) benign delayed reaction, (3) immediate reaction, and (4) severe cutaneous and extracutaneous drug reaction. Recommendations strictly depend on this classification and range from use of full-dose BLA or use of BLA under certain conditions (e.g., two-stage dose escalation, non-cross-reactive BLA only) to prohibiting all BLA and the use of alternative non-BLA. In case of suspected immediate or delayed allergic reactions, there is an additional recommendation regarding subsequent allergy testing during a symptom-free interval. Conclusion Triage of patients with suspected BLA is urgently required. While allergy testing, including provocation testing, represents the most reliable solution, this is not feasible in all patients due to the high prevalence of BLA allergies. The risk stratification algorithm developed for the authors’ hospital represents a tool suitable to making a contribution to rational antibiotic therapy. |
| abstract_unstemmed |
Background Beta-lactam antibiotics (BLA) are the treatment of choice for a large number of bacterial infections. Putative BLA allergies are often reported by patients, but rarely confirmed. Many patients do not receive BLA due to suspected allergy. There is no systematic approach to risk stratification in the case of a history of suspected BLA allergy. Methods Using the available stratification programs and taking current guidelines into account, an algorithm for risk stratification, including recommendations on the use of antibiotics in cases of compellingly indicated BLA despite suspected BLA allergy, was formulated by the authors for their maximum care university hospital. Results The hospital is in great need of recommendations on how to deal with BLA allergies. Patient-reported information in the history forms the basis for classifying the reactions into four risk categories: (1) BLA allergy excluded, (2) benign delayed reaction, (3) immediate reaction, and (4) severe cutaneous and extracutaneous drug reaction. Recommendations strictly depend on this classification and range from use of full-dose BLA or use of BLA under certain conditions (e.g., two-stage dose escalation, non-cross-reactive BLA only) to prohibiting all BLA and the use of alternative non-BLA. In case of suspected immediate or delayed allergic reactions, there is an additional recommendation regarding subsequent allergy testing during a symptom-free interval. Conclusion Triage of patients with suspected BLA is urgently required. While allergy testing, including provocation testing, represents the most reliable solution, this is not feasible in all patients due to the high prevalence of BLA allergies. The risk stratification algorithm developed for the authors’ hospital represents a tool suitable to making a contribution to rational antibiotic therapy. |
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Suspected penicillin allergy: risk assessment using an algorithm as an antibiotic stewardship project |
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Biedermann, Tilo Busch, Dirk H. Eisenhart-Rothe, Rüdiger Feihl, Susanne Filser, Christiane Gebhardt, Friedemann Heim, Markus Renz, Helmut Rothe, Kathrin Spinner, Christoph D. Starzner, Melanie Suren, Christian Trojan, Monika Brockow, Knut |
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Biedermann, Tilo Busch, Dirk H. Eisenhart-Rothe, Rüdiger Feihl, Susanne Filser, Christiane Gebhardt, Friedemann Heim, Markus Renz, Helmut Rothe, Kathrin Spinner, Christoph D. Starzner, Melanie Suren, Christian Trojan, Monika Brockow, Knut |
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| score |
7.399872 |