Drug Allergy
Key Points
Key Points
- Significant new information and recommendations update the 2010 drug allergy practice parameter.
- There is an overall de-emphasis on the use of skin testing as compared with drug challenge.
- More emphasis is placed on risk stratification based on reaction phenotype.
- When clinical probability of drug allergy is low, 1- or 2-step drug challenges are the preferred evaluation.
- For patients with reported penicillin allergy, proactive efforts should be made to delabel and also avoid unnecessary avoidance of non-cross reactive antibiotics.
- Consideration of phenotypes for adverse reactions to various non-antibiotic drugs (NSAIDs, biologics) should be used to guide evaluation and management.
Diagnosis
...agnosis
...Consensus-based Statements...
...rug challenges...
...We suggest that when the clinical probability of a...
2. We suggest that placebo-control...
...for delayed hypersensitivity reactions (HSRs)...
...uggest that for specific phenotypes of...
...a-lactams...
...mend that a proactive effort should be...
...commend against any testing in patients with a his...
...penicillin skin testing for patients wi...
...d against the routine use of multiple...
...recommend against penicillin skin...
...hat direct amoxicillin challenge b...
...st that for patients with a history of non-a...
...suggest that for patients with a history of ana...
...e suggest that for patients with a histo...
...hat for patients with a history of...
...t that in patients with a history of an u...
...st that in patients with a history of anaphyla...
...uggest against penicillin skin testing in pati...
.... We suggest that in patients with a hist...
...suggest that in patients with a history of peni...
...that allergist-immunologists collaborate with...
...fonamide...
...0. We suggest that for patients with a histo...
...roquinolones and macrolid...
...uggest using a 1- or 2-step drug c...
...teroidal anti-inflammatory drug (NSAID) hypersens...
...ggest a selective cyclooxygenase (...
...xacerbated respiratory disease (A...
...d against an oral aspirin challenge t...
...an oral aspirin challenge to confirm the d...
25. We suggest that a challenge procedure be u...
...NSAID-induced urticaria and angioedema...
...ts with NSAID-induced urticaria and a...
...ommon NSAID hypersensitivity clinical scenari...
...a 2-step aspirin challenge for patients with a hi...
...cer chemotherapeutic hypersensitivit...
...st that in patients with immediate reactions...
...t that patients with non-immediate reacti...
...atins
...e suggest that for patients with a history of imm...
...We suggest that for patients with a hi...
...c hypersensitivity
...that patients with non-immediate reaction...
...suggest that for patients with immediate r...
...cipients aller...
...suggest the clinician recognize that excip...
...ng Procedures for Delayed HSRsHavi...
...traindications to Drug ChallengesHaving trouble...
...rug Challenge Protocols for Immediate Reaction...
...-blind Placebo-controlled Challenge P...
Table 5. Single-blind Placebo-controlled Ch...
...en Drug Challengee Protocols for Non-se...
Table 7. Testing Options for Delayed HSRsHa...
...HLA Associations With Delayed Drug HSR...
Figure 1. Timeline of Drug HSRs a Acute generalize...
.... Drugs With No or Weak Evidence of Cross-...
Table 10. Groups of Beta-lactam Antibiotics...
...mediate Hypersensitivity Cephalosporin Skin...
.... Recommended Approach to Beta-lacta...
...ble 12. Criteria For 1- or 2-step TMP-SMX...
...lassification of Common Aspirin/NSAID HSRsHavi...
...X-1 and COX-2 Inhibiting Medications...
...linical Characteristics Determinin...
...raded Aspirin Challenge Protocol for Pat...
...8. Various Commonly Utilized Aspirin Desensitizati...
...Classification Based on Chemical S...
...able 20. Rapid Low Dose Aspirin Graded...
...idence and Characteristics of Chemotherapeuti...