title: Allergic Reactions in Hospitalized Patients With a Self-Reported Penicillin Allergy Who Receive a Cephalosporin or Meropenem.
abstract: BACKGROUND
  Cefepime and meropenem are used frequently in hospitalized patients for broad-spectrum empiric coverage, however, practitioners are often reluctant to prescribe these antibiotics for patients with a self-reported nonsevere, nontype I allergic reaction to penicillin.
  
  
  METHODS
  Retrospective review of electronic medical records of adults with a self-reported allergy to penicillin who received at least 1 dose of cefepime, ceftriaxone, cefoxitin, cephalexin, or meropenem to assess incidence and type of allergic reactions.
  
  
  RESULTS
  Of 175 patients included, 10 (6%) patients experienced an allergic reaction. The incidence for individual study drugs were cefepime 6% (6 of 96), meropenem 5% (3 of 56), cefoxitin 8% (1 of 13), ceftriaxone 0% (0 of 69), and cephalexin 0% (0 of 8). The majority of patients experienced a rash with or without pruritus and fever. Patients with a concomitant "sulfa" allergy (odds ratio [OR] 5.4, 95% confidence interval [CI] 1.4-21, P = .02) or ≥3 other drug allergies (OR 6.4, 95% CI 1.3-32, P = .025) were more likely to have an allergic reaction.
  
  
  CONCLUSIONS
  In one of the largest retrospective reviews of hospitalized patients who received full dose therapy with cefepime, ceftriaxone, and meropenem, the incidence of allergic reactions was low and reactions were mild. Cefepime, ceftriaxone, and meropenem can be considered for use in patients with a self-reported nontype I penicillin allergy.
authors.affiliation: 1 Department of Pharmacy, NSLIJ Huntington Hospital, Huntington, NY, USA.
authors.forename: Danielle Joset
authors.initials: DJ
authors.lastname: Crotty
authors.affiliation: 2 Department of Pharmacy, NYU Langone Medical Center, New York, NY, USA.
authors.forename: Xian Jie Cindy
authors.initials: XJ
authors.lastname: Chen
authors.affiliation: 2 Department of Pharmacy, NYU Langone Medical Center, New York, NY, USA.
authors.forename: Marco R
authors.initials: MR
authors.lastname: Scipione
authors.affiliation: 2 Department of Pharmacy, NYU Langone Medical Center, New York, NY, USA.
authors.forename: Yanina
authors.initials: Y
authors.lastname: Dubrovskaya
authors.affiliation: 3 Department of Medicine, NYU Langone Medical Center, New York, NY, USA.
authors.forename: Eddie
authors.initials: E
authors.lastname: Louie
authors.affiliation: 3 Department of Medicine, NYU Langone Medical Center, New York, NY, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Ladapo
authors.affiliation: 2 Department of Pharmacy, NYU Langone Medical Center, New York, NY, USA.
authors.forename: John
authors.initials: J
authors.lastname: Papadopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002511:Cephalosporins / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010406:Penicillins / Q000009:adverse effects*; D012189:Retrospective Studies; D057566:Self Report; D013845:Thienamycins / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D002511:Cephalosporins; D010406:Penicillins; D013845:Thienamycins; D000077731:Meropenem
keywords: allergic reactions; cephalosporins; meropenem; penicillin allergy