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 Con...
...Drug challenges...
...e suggest that when the clinical probabilit...
...e suggest that placebo-controlled...
...Testing for delayed...
...that for specific phenotypes of delayed drug HS...
...Beta-lacta...
...ecommend that a proactive effort should be mad...
...ecommend against any testing in patien...
...e suggest penicillin skin testing fo...
...e recommend against the routine use of mult...
...We recommend against penicillin skin testing pr...
...gest that direct amoxicillin challenge be consid...
10. We suggest that for patients with a histo...
11. We suggest that for patients with a history...
...suggest that for patients with a history of an...
...that for patients with a history of an unver...
...gest that in patients with a history of an...
...st that in patients with a history of anaphylaxi...
...suggest against penicillin skin test...
...est that in patients with a history of penic...
...e suggest that in patients with a his...
...ecommend that allergist-immunologists collaborate...
...Sulfonamid...
...suggest that for patients with a history...
...Fluoroquinolones...
...using a 1- or 2-step drug challenge without...
...Aspirin/no...
...We suggest a selective cyclooxygenase (CO...
...Aspirin exacerbated...
...3. We recommend against an oral aspi...
.... We suggest an oral aspirin challenge to c...
25. We suggest that a challenge procedur...
...Mult...
...patients with NSAID-induced urticaria and an...
...We suggest a 2-step aspirin challe...
...Cancer chemo...
...suggest that in patients with immediate reactions...
...that patients with non-immediate...
...Platin...
...suggest that for patients with a hist...
...We suggest that for patients with a history of i...
...Biologic hy...
...that patients with non-immediate reactions or a...
...hat for patients with immediate reactions or...
...Excipients aller...
34. We suggest the clinician recogn...
...ting Procedures for Delayed HSRs...
.... Contraindications to Drug Challenges...
...Open Drug Challenge Protocols for Immediate Rea...
...le-blind Placebo-controlled Challenge Protoc...
...le 5. Single-blind Placebo-controlled Challenge Pr...
...rug Challengee Protocols for Non-severe...
...e 7. Testing Options for Delayed HSRs...
...8. HLA Associations With Delayed D...
...re 1. Timeline of Drug HSRs a Acute...
...le 9. Drugs With No or Weak Evidenc...
...of Beta-lactam Antibiotics that Share Side Chain...
...mediate Hypersensitivity Cephalosporin Sk...
...ecommended Approach to Beta-lactam Administ...
...12. Criteria For 1- or 2-step TMP-S...
Table 13. Classification of Common As...
...e 15. COX-1 and COX-2 Inhibiting Medications...
...ble 16. Clinical Characteristics Determining...
...le 17. Graded Aspirin Challenge Pro...
...s Commonly Utilized Aspirin Desensitization Protoc...
...Table 19. N...
...id Low Dose Aspirin Graded Challenge for Ca...
...le 21. Incidence and Characteristics of Chemothe...