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
... List of Cons...
...Drug chal...
...suggest that when the clinical probability of...
...at placebo-controlled drug challen...
...Testi...
...suggest that for specific phenotypes of delayed...
...Beta-lactams...
...recommend that a proactive effort should be...
...end against any testing in patients with a hist...
...penicillin skin testing for patients with a...
...e recommend against the routine use of mult...
...We recommend against penicillin skin tes...
...suggest that direct amoxicillin challenge b...
...uggest that for patients with a history of non-ana...
...suggest that for patients with a history of anaph...
...We suggest that for patients with a history...
...ggest that for patients with a history of an u...
14. We suggest that in patients with...
...e suggest that in patients with a history of...
...suggest against penicillin skin testing in...
...that in patients with a history of penicillin...
.... We suggest that in patients with a h...
...mmend that allergist-immunologists collabora...
...Sulfo...
...We suggest that for patients with a history of be...
Fluo...
...We suggest using a 1- or 2-step drug chal...
...Aspirin/non-steroi...
...a selective cyclooxygenase (COX) -2 i...
...Aspi...
...recommend against an oral aspirin challenge...
...suggest an oral aspirin challenge to confirm th...
...gest that a challenge procedure be used to diagnos...
...Multiple NSAID-induc...
...patients with NSAID-induced urticaria and angioe...
...Com...
...We suggest a 2-step aspirin challenge for patie...
...Cancer chemot...
...gest that in patients with immediate reactions to...
...e suggest that patients with non-immedia...
...P...
...that for patients with a history of immedia...
...est that for patients with a history...
...Bi...
...e suggest that patients with non-immediate re...
...suggest that for patients with immed...
...Excipients allergy...
...est the clinician recognize that excipients are...
...g Procedures for Delayed HSRsHaving tro...
...raindications to Drug ChallengesHaving...
...pen Drug Challenge Protocols for Immedia...
...Single-blind Placebo-controlled Challen...
...e 5. Single-blind Placebo-controlled Challen...
...e 6. Open Drug Challengee Protocols for Non-...
...le 7. Testing Options for Delayed HSRsHavi...
...A Associations With Delayed Drug HS...
...Timeline of Drug HSRs a Acute generalized exa...
...gs With No or Weak Evidence of Cross-reactiv...
...ups of Beta-lactam Antibiotics that Sha...
...11. Immediate Hypersensitivity Cephalosporin...
...ommended Approach to Beta-lactam Administration...
.... Criteria For 1- or 2-step TMP-SMX O...
...assification of Common Aspirin/NSAID...
...COX-1 and COX-2 Inhibiting MedicationsHaving troub...
...inical Characteristics Determining...
...Graded Aspirin Challenge Protocol for Pati...
...ious Commonly Utilized Aspirin Desensitizat...
...Table 19....
...apid Low Dose Aspirin Graded Challenge for Cardio...
.... Incidence and Characteristics of Chemo...