Antibiotic allergy

K.G. Blumenthal; J.G. Peter; J.A. Trubiano; E.J. Phillips

doi:10.1016/S0140-6736(18)32218-9

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Journal article

Peer reviewed

Antibiotic allergy

K.G. Blumenthal, J.G. Peter, J.A. Trubiano and E.J. Phillips

The Lancet, Vol.393(10167), pp.183-198

2019

DOI: https://doi.org/10.1016/S0140-6736(18)32218-9

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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.

Details

Title: Antibiotic allergy
Authors/Creators: K.G. Blumenthal (Author/Creator)
J.G. Peter (Author/Creator)
J.A. Trubiano (Author/Creator)
E.J. Phillips (Author/Creator)
Publication Details: The Lancet, Vol.393(10167), pp.183-198
Publisher: Elsevier
Identifiers: 991005544449807891
Copyright: © 2018 Elsevier Ltd.
Murdoch Affiliation: Institute for Immunology and Infectious Diseases
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.265 Dermatology - Skin Allergies; 1.265.1140 Drug Hypersensitivity
Web Of Science research areas: Immunology
ESI research areas: Clinical Medicine