title: Brief communication: tolerability of meropenem in patients with IgE-mediated hypersensitivity to penicillins.
abstract: 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.
  
  
  METHODS
  Prospective skin testing and antibiotic challenge.
  
  
  METHODS
  Allergy units of 2 Italian medical centers.
  
  
  METHODS
  104 consecutive participants with immediate hypersensitivity reactions to penicillins and positive skin test results to at least 1 penicillin reagent.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Università Cattolica del Sacro Cuore, Complesso Integrato Columbus, Rome, Italy. antoninoromano@h-columbus.it
authors.forename: Antonino
authors.initials: A
authors.lastname: Romano
authors.forename: Marinella
authors.initials: M
authors.lastname: Viola
authors.forename: Rosa-Maria
authors.initials: RM
authors.lastname: Guéant-Rodriguez
authors.forename: Francesco
authors.initials: F
authors.lastname: Gaeta
authors.forename: Rocco
authors.initials: R
authors.lastname: Valluzzi
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Guéant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology; D000925:Anticoagulants / Q000627:therapeutic use; D003429:Cross Reactions; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000139:chemically induced*; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D010406:Penicillins / Q000009:adverse effects*; D011446:Prospective Studies; D012882:Skin Tests; D013845:Thienamycins / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D010406:Penicillins; D013845:Thienamycins; D000077731:Meropenem