Desensitization as a tool for beta-lactam antibiotic use in methicillin sensitive Staphylococcus aureus infections

Self-reporting of antimicrobial allergies among hospitalized patients is quite common, with up to 25% of patients reporting at least one antimicrobial allergy. While it is important that patients report all suspected allergies, clinician documentation detailing the nature and severity of the reaction is often lacking. Of those patients reporting an allergy, only 4% of documented allergies had a specific type of reaction provided in the medical chart.

It is estimated that about 15.6% of patients report having a beta-lactam allergy, however, estimates are much lower for patients that actually exhibit a severe allergic reaction preventing their use. Skin testing, in vivo radioallergosorben testing (RAST), and provocation tests can be done to diagnose a true drug hypersensitivity.In a study evaluating patients with a history of cephalosporin allergy, only 40.1% ofallergies were confirmed by these methods. Although oral provocation testing is considered the gold standard in diagnosis, it is infrequently used due to the need for close observation and risk of severe uncontrollable reactions. In children with a history of a penicillin or cephalosporin allergy, only 58.3% of allergies were confirmed with positive skin or challenge testing.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-pharmacy/