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
Diagnosis
... List of Consensus-based S...
...ug challeng...
...We suggest that when the clinical p...
...est that placebo-controlled drug challen...
...sting for delayed hypersensitivity reactions...
...suggest that for specific phenotypes of...
...ta-lacta...
...recommend that a proactive effort...
...ommend against any testing in patients with a hi...
...penicillin skin testing for patients with a...
...We recommend against the routine use of multipl...
...against penicillin skin testing prior...
...gest that direct amoxicillin challenge...
.... We suggest that for patients with a hist...
...suggest that for patients with a history of ana...
...t that for patients with a history of anaphylaxis...
13. We suggest that for patients with...
...4. We suggest that in patients with...
...t that in patients with a history of anaphylax...
...gainst penicillin skin testing in patie...
...suggest that in patients with a history...
...We suggest that in patients with a history of...
...e recommend that allergist-immunologists co...
...onamides...
...We suggest that for patients with a history of...
...uoroquinolones and ma...
...est using a 1- or 2-step drug challenge without...
...non-steroidal anti-inflammatory drug (...
...st a selective cyclooxygenase (COX) -2 inhibi...
...spirin exacerbated respiratory disease (AE...
...We recommend against an oral aspirin challen...
24. We suggest an oral aspirin challen...
...that a challenge procedure be used to diag...
...NSAID-induced urticaria and angioedema
26. For patients with NSAID-induced u...
...NSAID hypersensitivity clinical scenarios...
...st a 2-step aspirin challenge for patie...
...chemotherapeutic hypersensitivity
...e suggest that in patients with im...
...est that patients with non-immediate reactions...
...latin...
...suggest that for patients with a history of im...
...ggest that for patients with a history of im...
Biologic hypersensit...
.... We suggest that patients with non-immediate rea...
...est that for patients with immediate r...
...ipients aller...
...uggest the clinician recognize that ex...
...Testing Procedures for Delayed HSRsHaving...
...3. Contraindications to Drug ChallengesHa...
...Open Drug Challenge Protocols for Immediate Rea...
...gle-blind Placebo-controlled Challenge Prot...
...ngle-blind Placebo-controlled Challenge Protocol...
...able 6. Open Drug Challengee Protoco...
...ing Options for Delayed HSRsHaving trou...
...ble 8. HLA Associations With Delayed Dr...
...imeline of Drug HSRs a Acute generalize...
...Drugs With No or Weak Evidence of Cross...
...ups of Beta-lactam Antibiotics that Share Si...
.... Immediate Hypersensitivity Cephalosporin Skin Te...
...ecommended Approach to Beta-lactam Adm...
...Criteria For 1- or 2-step TMP-SMX Or...
...Classification of Common Aspirin/NSAID HSR...
...ble 15. COX-1 and COX-2 Inhibiting...
...16. Clinical Characteristics Determining the Need...
...e 17. Graded Aspirin Challenge Protocol for Pa...
...8. Various Commonly Utilized Aspirin Desensitiz...
...ble 19. NSAID Classification Based on Che...
...d Low Dose Aspirin Graded Challenge for Cardiovas...
...cidence and Characteristics of Chemot...