Antibiotic allergy

Review

关键词: IGE-MEDIATED HYPERSENSITIVITY;    REPORTED PENICILLIN ALLERGY;    TOXIC EPIDERMAL NECROLYSIS;    STEVENS-JOHNSON-SYNDROME;    ADVERSE DRUG-REACTIONS;    SKIN-TEST CONCENTRATIONS;    BETA-LACTAM ANTIBIOTICS;    CROSS-REACTIVITY;    HOSPITALIZED-PATIENTS;    CUTANEOUS REACTIONS;   

DOI  :  10.1016/S0140-6736(18)32218-9

来源: SCIE

【 摘 要 】

Antibiotics are the commonest cause of life-threatening immune-mediated drug reactions that are considered off-target, including anaphylaxis, and organ-specific and severe cutaneous adverse reactions. However, many antibiotic reactions documented as allergies were unknown or not remembered by the patient, cutaneous reactions unrelated to drug hypersensitivity, drug-infection interactions, or drug intolerances. Although such reactions pose negligible risk to patients, they currently represent a global threat to public health. Antibiotic allergy labels result in displacement of first-line therapies for antibiotic prophylaxis and treatment. A penicillin allergy label, in particular, is associated with increased use of broad-spectrum and non-beta-lactam antibiotics, which results in increased adverse events and antibiotic resistance. Most patients labelled as allergic to penicillins are not allergic when appropriately stratified for risk, tested, and re-challenged. Given the public health importance of penicillin allergy, this Review provides a global update on antibiotic allergy epidemiology, classification, mechanisms, and management.

【 授权许可】

Free