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|Authors:||Blumenthal, Kimberly G;Peter, Jonny G;Trubiano, Jason A;Phillips, Elizabeth J|
|Affiliation:||Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA|
Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
The National Centre for Infections in Cancer, Peter McCallum Cancer Centre, Melbourne, VIC, Australia
Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa
|Citation:||Lancet 2018; 393(10167): 183-198|
|Abstract:||Antibiotics are the commonest cause of life-threatening immune-mediated drug reactions that are considered off-target, including anaphylaxis, and organ-specific and severe cutaneous adverse reactions. However, many antibiotic reactions documented as allergies were unknown or not remembered by the patient, cutaneous reactions unrelated to drug hypersensitivity, drug-infection interactions, or drug intolerances. Although such reactions pose negligible risk to patients, they currently represent a global threat to public health. Antibiotic allergy labels result in displacement of first-line therapies for antibiotic prophylaxis and treatment. A penicillin allergy label, in particular, is associated with increased use of broad-spectrum and non-β-lactam antibiotics, which results in increased adverse events and antibiotic resistance. Most patients labelled as allergic to penicillins are not allergic when appropriately stratified for risk, tested, and re-challenged. Given the public health importance of penicillin allergy, this Review provides a global update on antibiotic allergy epidemiology, classification, mechanisms, and management.|
|Appears in Collections:||Journal articles|
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