title: Practical aspects of choosing an antibiotic for patients with a reported allergy to an antibiotic.
abstract: Physicians often must select antibiotics for patients who are reported to have an antibiotic allergy. For penicillins, the sensitivity of penicillin skin testing for predicting serious allergic reactions is excellent. For other beta-lactam antibiotics, penicillin skin testing is useful for excluding the possibility of sensitivity to the beta-lactam ring. For other antibiotics, the patient history remains the most useful tool for determining whether a serious reaction is likely to occur with further drug exposure. The cross-reactivity between penicillins and second- or third-generation cephalosporins (excluding cefamandole) is probably no higher than is the cross-reactivity between penicillins and other classes of antibiotics. When a patient has a suspected immunoglobulin E-mediated antibiotic allergy, desensitization therapy should be considered, if the efficacy of alternate antibiotics is in doubt. For the treatment of serious infections, it is usually possible to safely administer the antibiotic of choice despite a history of possible antibiotic allergy.
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, AB, Canada, T6G 2B7. jr3@gpu.srv.ualberta.ca
authors.forename: Joan L
authors.initials: JL
authors.lastname: Robinson
authors.forename: Tahir
authors.initials: T
authors.lastname: Hameed
authors.forename: Stuart
authors.initials: S
authors.lastname: Carr
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000191:economics; D003937:Diagnosis, Differential; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D011307:Drug Prescriptions; D004363:Drug Utilization; D006801:Humans; D007769:Lactams; D010406:Penicillins / Q000009:adverse effects; D012882:Skin Tests
chemical_list: D000900:Anti-Bacterial Agents; D007769:Lactams; D010406:Penicillins