History of Allergy to One β-Lactam Antibiotic Is Not a Reason to Avoid All β-Lactams

In patients with gram-negative bloodstream infections, benefits of appropriate empirical antibacterial therapy outweighed risk for allergic reactions.

Most patients labeled as penicillin-allergic are not truly allergic. Studies have shown higher costs and worse outcomes when alternative antibiotics are substituted for first-line β-lactams. Even truly penicillin-allergic patients generally will tolerate a cephalosporin or carbapenem, because these reactions are mediated by side chains rather than the β-lactam ring. Guidelines still recommend penicillin skin-testing or graded challenges before giving other β-lactams to penicillin-allergic patients; however, this scheme is not practical for patients with life-threatening infections such as gram-negative bacilli bloodstream infections (GNB BSI).

U.S. investigators retrospectively examined data on 433 patients with GNB BSI and histories of β-la…

Reviewing Author

David J. Amrol, MD

Disclosures

Speaker’s BureauAstraZeneca; Incyte

David J. Amrol, MD

Disclosures

Speaker’s BureauAstraZeneca; Incyte

History of Allergy to One β-Lactam Antibiotic Is Not a Reason to Avoid All β-Lactams

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Reviewing Author