DOCSLIB.ORG

Guidance on Penicillin Allergy

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Guidance on Penicillin Allergy Guidance on Penicillin Allergy A significant proportion of patients are incorrectly labeled “penicillin allergic” either on the basis of symptoms reflecting drug side-effects (e.g. nausea, diarrhoea) as opposed to allergy or on the basis of an inadequate history. To do so may deny the patient potentially life-saving treatment. A thorough, reliable history (from patient or family/ General Practitioner) is paramount to identify those with true allergy, be it mild or severe (anaphylaxis). Every effort should be made to document the exact nature of the patient’s drug allergy to penicillins/ beta-lactams MUST on the allergy section of the drug card and in the patients notes. Characteristics Type I immediate Non-Type I reactions hypersensitivity reactions (Types II-IV and idiosyncratic) (ANAPHYLACTOID) Timing of onset 1 to 4 hours from exposure >72 hours from exposure (can occur up to 72 hours) Clinical signs Anaphylaxis Maculopapular rash Laryngeal oedema Morbilliform rash Wheezing / bronchospasm red blood cells / platelets Angioedema Drug fever (serum sickness) Urticaria / pruritis Tissue injury (immune complex) Diffuse erythema Contact dermatitis Classification SEVERE, life-threatening NON-SEVERE penicillin allergy Penicillin (and Beta-lactam allergy) Avoid all drugs in RED and Avoid all drugs in RED YELLOW below Drugs in YELLOW can be used with caution- a proportion of patients will cross-react. Red- Penicillins Yellow- other Beta-Lactams Amoxicillin Cefaclor Augmentin (co-amoxiclav) Cefalexin Benzathine penicillin Cefixime Benzylpenicillin (Penicillin G) Cefotaxime Flucloxacillin Ceftazidime Penicillin V (phenoxymethylpenicillin) Ceftriaxone Piperacillin Cefuroxime Procaine penicillin Ertapenem Tazocin (piperacillin / tazobactam) Imipenem (Primaxin) Timentin (ticarcillin / clavulanic acid) Meropenem Doripenem Aztreonam See Below for the RBCH Penicillin Allergy Traffic Light Card RBCH Foundation Trust. Guidance on Penicillin Allergy. RBCH AMT August 2011 (v2011.0) Page 1 of 2 The Royal Bournemouth and PHARMACY DEPARTMENT Christchurch Hospitals NHS (With acknowledgements to Foundation Trust King’s College Hospital Pharmacy Department) PENICILLIN ALLERGY – Antibiotic prescribing in a penicillin allergic patient Amoxicillin Ampicillin ® Augmentin (co-amoxiclav) Flucloxacillin CONTRA- Penicillin G (benzylpenicillin) INDICATED Penicillin V (phenoxymethyl- penicillin) (see notes below) Tazocin® (piperacillin plus tazobactam) ® Timentin (ticarcillin) Cefaclor Cefotaxime Cefradine/ Cefalexin Cefixime Ceftazidime Ceftriaxone Cefuroxime CAUTION Primaxin® (Imipenem plus (see notes below) cilastin) Meropenem Doripenem Ertapenem Aztreonam Amikacin Minocycline Azithromycin Moxifloxacin Chloramphenicol Nitrofurantoin Ciprofloxacin Norfloxacin Clarithromycin Oxytetracycline Clindamycin Rifampicin CONSIDERED Colistin Sodium Fusidate Co-trimoxazole Synercid SAFE Daptomycin Teicoplanin Doxycycline Tetracycline Erythromycin Tigecycline Gentamicin Trimethoprim Linezolid Tobramycin Metronidazole Vancomycin NOTES: Please seek expert microbiology advice in cases of severe infection. Individuals with a documented history of anaphylaxis, immediately after penicillin administration are at risk of immediate hypersensitivity to a penicillin: these individuals should not receive a penicillin, a cephalosporin or other beta-lactam antibiotic. Please discuss alternative therapy with a medical microbiologist. RBCH Foundation Trust. Guidance on Penicillin Allergy. RBCH AMT August 2011 (v2011.0) Page 2 of 2 .
Load more

Recommended publications
  • Medical Review(S) Clinical Review
    CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 200327 MEDICAL REVIEW(S) CLINICAL REVIEW Application Type NDA Application Number(s) 200327 Priority or Standard Standard Submit Date(s) December 29, 2009 Received Date(s) December 30, 2009 PDUFA Goal Date October 30, 2010 Division / Office Division of Anti-Infective and Ophthalmology Products Office of Antimicrobial Products Reviewer Name(s) Ariel Ramirez Porcalla, MD, MPH Neil Rellosa, MD Review Completion October 29, 2010 Date Established Name Ceftaroline fosamil for injection (Proposed) Trade Name Teflaro Therapeutic Class Cephalosporin; ß-lactams Applicant Cerexa, Inc. Forest Laboratories, Inc. Formulation(s) 400 mg/vial and 600 mg/vial Intravenous Dosing Regimen 600 mg every 12 hours by IV infusion Indication(s) Acute Bacterial Skin and Skin Structure Infection (ABSSSI); Community-acquired Bacterial Pneumonia (CABP) Intended Population(s) Adults ≥ 18 years of age Template Version: March 6, 2009 Reference ID: 2857265 Clinical Review Ariel Ramirez Porcalla, MD, MPH Neil Rellosa, MD NDA 200327: Teflaro (ceftaroline fosamil) Table of Contents 1 RECOMMENDATIONS/RISK BENEFIT ASSESSMENT ......................................... 9 1.1 Recommendation on Regulatory Action ........................................................... 10 1.2 Risk Benefit Assessment.................................................................................. 10 1.3 Recommendations for Postmarketing Risk Evaluation and Mitigation Strategies ........................................................................................................................
    [Show full text]
  • Cefoxitin Versus Piperacillin– Tazobactam As Surgical Antibiotic Prophylaxis in Patients Undergoing Pancreatoduodenectomy: Protocol for a Randomised Controlled Trial
    Open access Protocol BMJ Open: first published as 10.1136/bmjopen-2020-048398 on 4 March 2021. Downloaded from Cefoxitin versus piperacillin– tazobactam as surgical antibiotic prophylaxis in patients undergoing pancreatoduodenectomy: protocol for a randomised controlled trial Nicole M Nevarez ,1 Brian C Brajcich,2 Jason Liu,2,3 Ryan Ellis,2 Clifford Y Ko,2 Henry A Pitt,4 Michael I D'Angelica,5 Adam C Yopp1 To cite: Nevarez NM, ABSTRACT Strengths and limitations of this study Brajcich BC, Liu J, et al. Introduction Although antibiotic prophylaxis is Cefoxitin versus piperacillin– established in reducing postoperative surgical site tazobactam as surgical ► A major strength of this study is the multi- infections (SSIs), the optimal antibiotic for prophylaxis in antibiotic prophylaxis institutional, double- arm, randomised controlled in patients undergoing pancreatoduodenectomy (PD) remains unclear. The study trial design. objective is to evaluate if administration of piperacillin– pancreatoduodenectomy: ► A limitation of this study is that all perioperative care protocol for a randomised tazobactam as antibiotic prophylaxis results in decreased is at the discretion of the operating surgeon and is controlled trial. BMJ Open 30- day SSI rate compared with cefoxitin in patients not standardised. 2021;11:e048398. doi:10.1136/ undergoing elective PD. ► All data will be collected through the American bmjopen-2020-048398 Methods and analysis This study will be a multi- College of Surgeons National Surgical Quality ► Prepublication history for institution, double- arm, non- blinded randomised controlled Improvement Program, which is a strength for its this paper is available online. superiority trial. Adults ≥18 years consented to undergo PD ease of use but a limitation due to the variety of data To view these files, please visit for all indications who present to institutions participating included.
    [Show full text]
  • Prevalence of Self-Medication of Antibiotics Among People In
    International Journal of Pharmacy Teaching & Practices 2013, Vol.4, Issue 1, 504-510. Prevalence of self-medication of antibiotics among people in Bangladesh Nishat Chowdhury*, Mohammad Rashedul Islam, Md. Mehedi Hasan, Md. Mahmudur Rouf *Department of Pharmacy, State University of Bangladesh, Dhanmondi, Dhaka, Bangladesh Introduction Research Article Widespread and inappropriate use of antibiotics increases health care costs (1) and contributes to Please cite this paper as: Nishat Chowdhury*, Mohammad Rashedul Islam, Md. Mehedi Hasan, Md. Mahmudur Rouf. Prevalence of self- antibiotic resistance (2)。 Antimicrobial medication medication of antibiotics among people in Bangladesh . IJPTP, 2013, management in Bangladesh has been highlighted by 4(1), 504-510. previous studies as an area for improvement (3). Corresponding Author: There is already enough evidence of growing resistance to antimicrobials in this country resulting Nishat Chowdhury, from misuse (4-6). Previous study showed that Department of Pharmacy, State University of Bangladesh, antimicrobials are widely available (18% incidents) in Dhanmondi, Dhaka, Bangladesh the home medicine cabinets of the Dhaka City Telephone -88028612992, population (7). Since there is no prescription-only Email: [email protected] drug in Bangladesh, people can purchase drugs like sedatives, antimicrobials without prescription even in the remote parts of the country (8-9). The relative Abstract lack of data on the morbidity and mortality attributable to antibiotic resistance, including the This study attempts to investigate the prevalence of self- economic impact on individuals as well as on health medication of antibiotics among people in Bangladesh.This care and societies, may explain the weak reaction study was conducted in six districts of Bangladesh (Dhaka, from politicians, public health workers, and Munshiganj, Kishoreganj, Chittagong, Chandpur, Kushtia) by consumers to this threat to public health (10).
    [Show full text]
  • Efficacy of Amoxicillin and Amoxicillin/Clavulanic Acid in the Prevention of Infection and Dry Socket After Third Molar Extraction
    Med Oral Patol Oral Cir Bucal. 2016 Jul 1;21 (4):e494-504. Amoxicillin in the prevention of infectious complications after tooth extraction Journal section: Oral Surgery doi:10.4317/medoral.21139 Publication Types: Review http://dx.doi.org/doi:10.4317/medoral.21139 Efficacy of amoxicillin and amoxicillin/clavulanic acid in the prevention of infection and dry socket after third molar extraction. A systematic review and meta-analysis María-Iciar Arteagoitia 1, Luis Barbier 2, Joseba Santamaría 3, Gorka Santamaría 4, Eva Ramos 5 1 MD, DDS, PhD, Associate Professor, Stomatology I Department, University of the Basque Country (UPV/EHU), BioCruces Health Research Institute, Spain; Consolidated research group (UPV/EHU IT821-13) 2 MD PhD, Chair Professor, Maxillofacial Surgery Department, BioCruces Health Research Institute, Cruces University Hos- pital, University of the Basque Country (UPV/EHU), Spain; Consolidated research group (UPV/EHU IT821-13) 3 MD, DDS, PhD, Professor and Chair, Maxillofacial Surgery Department, Bio Cruces Health Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Bizkaia, Spain; Consolidated research group (UPV/EHU IT821-13) 4 DDS, PhD, Associate Professor, Stomatology I Department, University of the Basque Country (UPV/EHU), BioCruces Health Research Institute, Spain; Consolidated research group (UPV/EHU IT821-13) 5 PhD, Degree in Farmacy, BioCruces Health Research Institute, Cruces University Hospital. Spain Correspondence: Servicio Cirugía Maxilofacial Hospital Universitario de Cruces Plaza de Cruces s/n Arteagoitia MI, Barbier L, Santamaría J, Santamaría G, Ramos E. Ef- Barakaldo, Bizkaia, Spain ficacy of amoxicillin and amoxicillin/clavulanic acid in the prevention [email protected] of infection and dry socket after third molar extraction.
    [Show full text]
  • Cefalexin in the WHO Essential Medicines List for Children Reject
    Reviewer No. 1: checklist for application of: Cefalexin In the WHO Essential Medicines List for Children (1) Have all important studies that you are aware of been included? Yes No 9 (2) Is there adequate evidence of efficacy for the proposed use? Yes 9 No (3) Is there evidence of efficacy in diverse settings and/or populations? Yes 9 No (4) Are there adverse effects of concern? Yes 9 No (5) Are there special requirements or training needed for safe/effective use? Yes No 9 (6) Is this product needed to meet the majority health needs of the population? Yes No 9 (7) Is the proposed dosage form registered by a stringent regulatory authority? Yes 9 No (8) What action do you propose for the Committee to take? Reject the application for inclusion of the following presentations of cefalexin: • Tablets/ capsules 250mg • Oral suspensions 125mg/5ml and 125mg/ml (9) Additional comment, if any. In order to identify any additional literature, the following broad and sensitive search was conducted using the PubMed Clinical Query application: (cephalexin OR cefalexin AND - 1 - pediatr*) AND ((clinical[Title/Abstract] AND trial[Title/Abstract]) OR clinical trials[MeSH Terms] OR clinical trial[Publication Type] OR random*[Title/Abstract] OR random allocation[MeSH Terms] OR therapeutic use[MeSH Subheading]) Only one small additional study was identified, which looked at the provision of prophylactic antibiotics in patients presenting to an urban children's hospital with trauma to the distal fingertip, requiring repair.1 In a prospective randomised control trial, 146 patients were enrolled, of which 69 were randomised to the no-antibiotic group, and 66 were randomised to the antibiotic (cefalexin) group.
    [Show full text]
  • Clinical Review (Cubicin)
    Clinical Review Amol Purandare, MD NDA 021572 Cubicin (Daptomycin for injection) CLINICAL REVIEW Application Type NDA supplement Application Number(s) 21572 Priority or Standard Priority Submit Date(s) June 30, 2016 Received Date(s) June 30, 2016 PDUFA Goal Date March 30, 2017 (Major amendment) Division / Office DAIP/OAP Reviewer Name(s) Amol Purandare, MD Review Completion Date March 23, 2017 Established Name Daptomycin (Proposed) Trade Name Cubicin Therapeutic Class Cyclic Lipopeptide Applicant Cubist Pharmaceuticals Formulation(s) Injection Dosing Regimen 5 mg/kg (12-<18 years), 7 mg/kg (7-11 years), 9 mg/kg (2-6 years), and 10 mg/kg (1-< 2 years) Indication(s) Complicated Skin and Skin Structure Infections 1 Reference ID: 4075320 Clinical Review Amol Purandare, MD NDA 021572 Cubicin (Daptomycin for injection) Intended Population(s) Ages 1 year to <18 years Table of Contents 1 RECOMMENDATIONS/RISK BENEFIT ASSESSMENT..........................................6 1.1 Recommendation on Regulatory Action ..............................................................6 1.2 Risk Benefit Assessment .....................................................................................6 1.3 Recommendations for Postmarket Risk Evaluation and Mitigation Strategies ....6 1.4 Recommendations for Postmarket Requirements and Commitments.................7 2 INTRODUCTION AND REGULATORY BACKGROUND .........................................7 2.1 Product Information .............................................................................................7
    [Show full text]
  • Severe Sepsis and Septic Shock Antibiotic Guide
    Stanford Health Issue Date: 05/2017 Stanford Antimicrobial Safety and Sustainability Program Severe Sepsis and Septic Shock Antibiotic Guide Table 1: Antibiotic selection options for healthcare associated and/or immunocompromised patients • Healthcare associated: intravenous therapy, wound care, or intravenous chemotherapy within the prior 30 days, residence in a nursing home or other long-term care facility, hospitalization in an acute care hospital for two or more days within the prior 90 days, attendance at a hospital or hemodialysis clinic within the prior 30 days • Immunocompromised: Receiving chemotherapy, known systemic cancer not in remission, ANC <500, severe cell-mediated immune deficiency Table 2: Antibiotic selection options for community acquired, immunocompetent patients Table 3: Antibiotic selection options for patients with simple sepsis, community acquired, immunocompetent patients requiring hospitalization. Risk Factors for Select Organisms P. aeruginosa MRSA Invasive Candidiasis VRE (and other resistant GNR) Community acquired: • Known colonization with MDROs • Central venous catheter • Liver transplant • Prior IV antibiotics within 90 day • Recent MRSA infection • Broad-spectrum antibiotics • Known colonization • Known colonization with MDROs • Known MRSA colonization • + 1 of the following risk factors: • Prolonged broad antibacterial • Skin & Skin Structure and/or IV access site: ♦ Parenteral nutrition therapy Hospital acquired: ♦ Purulence ♦ Dialysis • Prolonged profound • Prior IV antibiotics within 90 days ♦ Abscess
    [Show full text]
  • Severe Sepsis Tipsheet
    Severe Sepsis Tipsheet SEVERE SEPSIS A, B, and C of the following must be met within 6 hours of each other. A. Documentation of a suspected infection. There may be reference to “possible infection,” “suspect infection,” “rule out infection,” or similar documentation. B. TWO or more manifestations of systemic infection according to the Systemic Inflammatory Response Syndrome (SIRS) criteria, which are: • Temperature > 38.3 C or < 36.0 C (> 100.9 F or < 96.8 F) • Heart rate (pulse) > 90 • Respiration > 20 per minute • White blood cell count > 12,000 or < 4,000 or > 10% bands C. Organ dysfunction, evidenced by any one of the following: • Systolic blood pressure (SBP) < 90 mmHg, or mean arterial pressure < 65 mmHg, or a systolic blood pressure decrease of more than 40 mmHg. Physician/APN/PA documentation must be present in the medical record indicating a > 40 mmHg decrease in SBP has occurred and is related to infection, severe sepsis or septic shock and not other causes. • Acute respiratory failure as evidenced by a new need for invasive or non-invasive mechanical ventilation. To use acute respiratory failure as a sign of organ dysfunction there must be: • Documentation of acute respiratory failure AND • Documentation the patient is on mechanical ventilation • Invasive mechanical ventilation requires an endotracheal or tracheostomy tube. Non-invasive mechanical ventilation may be referred to as BiPAP or CPAP. • New need for mechanical ventilation indicates the patient was not using the same type of mechanical ventilation prior to the current acute respiratory failure. • Use the time at which there is documentation the patient has both acute respiratory failure and is on mechanical ventilation.
    [Show full text]
  • Antimicrobial Surgical Prophylaxis
    Antimicrobial Surgical Prophylaxis The antimicrobial surgical prophylaxis protocol establishes evidence-based standards for surgical prophylaxis at The Nebraska Medical Center. The protocol was adapted from the recently published consensus guidelines from the American Society of Health-System Pharmacists (ASHP), Society for Healthcare Epidemiology of America (SHEA), Infectious Disease Society of America (IDSA), and the Surgical Infection Society (SIS) and customized to Nebraska Medicine with the input of the Antimicrobial Stewardship Program in concert with the various surgical groups at the institution. The protocol established here-in will be implemented via standard order sets utilized within One Chart. Routine surgical prophylaxis and current and future surgical order sets are expected to conform to this guidance. Antimicrobial Surgical Prophylaxis Initiation Optimal timing: Within 60 minutes before surgical incision o Exceptions: Fluoroquinolones and vancomycin (within 120 minutes before surgical incision) Successful prophylaxis necessitates that the antimicrobial agent achieve serum and tissue concentrations above the MIC for probable organisms associated with the specific procedure type at the time of incision as well as for the duration of the procedure. Renal Dose Adjustment Guidance The following table can be utilized to determine if adjustments are needed to antimicrobial surgical prophylaxis for both pre-op and post-op dosing. Table 1 Renal Dosage Adjustment Dosing Regimen with Dosing Regimen with CrCl Dosing Regimen with
    [Show full text]
  • Medicines to Treat Bacterial Infections
    Government of Western Australia North Metropolitan Health Service Women and Newborn Health Service Medicines to treat bacterial infections This brochure contains some information on Important: Antibiotic resistance can the medicines you may have been prescribed affect us all. to treat a bacterial infection either in hospital or on discharge. Please talk to your doctor or Help limit the development of antibiotic pharmacist if you would like more information resistance by using antibiotics correctly. on a specific antibiotic. Make sure you: Take antibiotics exactly as prescribed. What is an antibiotic? • Antibiotics are medicines used to treat • Follow instructions on how many times a infections caused by bacteria. They are not day and for how long to take them. effective against viral infections such as the • Do not stop treatment early, even if you common cold and the ‘flu’. feel better. Medicine Other information Amoxicillin May be taken with or without food. Amoxicillin/ Take with the first bite of a meal. clavulanic acid Cefalexin May be taken with or without food. Take on an empty stomach with a glass of water, 1 hour before or 2 hours after food. Ciprofloxacin Do not take dairy products, antacids, iron, zinc or calcium within 2 hours of the dose. Clindamycin Take with a full glass of water. May be taken with or without food. Take with food or milk. Remain upright for an hour after dose to prevent damage to the Doxycycline lining of your throat. Do not take dairy products, antacids, iron, zinc or calcium within 2 hours of the dose. Take on an empty stomach, 1 hour before or 2 hours after food.
    [Show full text]
  • Antimicrobial Resistance Benchmark 2020 Antimicrobial Resistance Benchmark 2020
    First independent framework for assessing pharmaceutical company action Antimicrobial Resistance Benchmark 2020 Antimicrobial Resistance Benchmark 2020 ACKNOWLEDGEMENTS The Access to Medicine Foundation would like to thank the following people and organisations for their contributions to this report.1 FUNDERS The Antimicrobial Resistance Benchmark research programme is made possible with financial support from UK AID and the Dutch Ministry of Health, Welfare and Sport. Expert Review Committee Research Team Reviewers Hans Hogerzeil - Chair Gabrielle Breugelmans Christine Årdal Gregory Frank Fatema Rafiqi Karen Gallant Nina Grundmann Adrián Alonso Ruiz Hans Hogerzeil Magdalena Kettis Ruth Baron Hitesh Hurkchand Joakim Larsson Dulce Calçada Joakim Larsson Marc Mendelson Moska Hellamand Marc Mendelson Margareth Ndomondo-Sigonda Kevin Outterson Katarina Nedog Sarah Paulin (Observer) Editorial Team Andrew Singer Anna Massey Deirdre Cogan ACCESS TO MEDICINE FOUNDATION Rachel Jones The Access to Medicine Foundation is an independent Emma Ross non-profit organisation based in the Netherlands. It aims to advance access to medicine in low- and middle-income Additional contributors countries by stimulating and guiding the pharmaceutical Thomas Collin-Lefebvre industry to play a greater role in improving access to Alex Kong medicine. Nestor Papanikolaou Address Contact Naritaweg 227-A For more information about this publication, please contact 1043 CB, Amsterdam Jayasree K. Iyer, Executive Director The Netherlands [email protected] +31 (0) 20 215 35 35 www.amrbenchmark.org 1 This acknowledgement is not intended to imply that the individuals and institutions referred to above endorse About the cover: Young woman from the Antimicrobial Resistance Benchmark methodology, Brazil, where 40%-60% of infections are analyses or results.
    [Show full text]
  • Antibiotic Use Guidelines for Companion Animal Practice (2Nd Edition) Iii
    ii Antibiotic Use Guidelines for Companion Animal Practice (2nd edition) iii Antibiotic Use Guidelines for Companion Animal Practice, 2nd edition Publisher: Companion Animal Group, Danish Veterinary Association, Peter Bangs Vej 30, 2000 Frederiksberg Authors of the guidelines: Lisbeth Rem Jessen (University of Copenhagen) Peter Damborg (University of Copenhagen) Anette Spohr (Evidensia Faxe Animal Hospital) Sandra Goericke-Pesch (University of Veterinary Medicine, Hannover) Rebecca Langhorn (University of Copenhagen) Geoffrey Houser (University of Copenhagen) Jakob Willesen (University of Copenhagen) Mette Schjærff (University of Copenhagen) Thomas Eriksen (University of Copenhagen) Tina Møller Sørensen (University of Copenhagen) Vibeke Frøkjær Jensen (DTU-VET) Flemming Obling (Greve) Luca Guardabassi (University of Copenhagen) Reproduction of extracts from these guidelines is only permitted in accordance with the agreement between the Ministry of Education and Copy-Dan. Danish copyright law restricts all other use without written permission of the publisher. Exception is granted for short excerpts for review purposes. iv Foreword The first edition of the Antibiotic Use Guidelines for Companion Animal Practice was published in autumn of 2012. The aim of the guidelines was to prevent increased antibiotic resistance. A questionnaire circulated to Danish veterinarians in 2015 (Jessen et al., DVT 10, 2016) indicated that the guidelines were well received, and particularly that active users had followed the recommendations. Despite a positive reception and the results of this survey, the actual quantity of antibiotics used is probably a better indicator of the effect of the first guidelines. Chapter two of these updated guidelines therefore details the pattern of developments in antibiotic use, as reported in DANMAP 2016 (www.danmap.org).
    [Show full text]