Article

Imipenem in Patients with Immediate Hypersensitivity to Penicillins

Catholic University of the Sacred Heart , Milano, Lombardy, Italy
New England Journal of Medicine (Impact Factor: 55.87). 07/2006; 354(26):2835-7. DOI: 10.1056/NEJMc053529
Source: PubMed
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    • "Proven IgE- mediated Positive Serbia 3–14 81 Imipenem and meropenem 0 0 0 0 0 Cunha et al (2008) [11] Proven IgE- mediated NR United States 28–94 51 Meropenem 0 0 0 0 0 Atanaskovic´- Markovicét al (2009) [7] Proven IgE- mediated Positive Serbia 3–14 42 Imipenem 0 0 0 0 0 Atanaskovic´- Markovicét al (2008) [9] Proven IgE- mediated Positive Serbia 3–14 26 Meropenem 0 0 0 0 0 Sodhi et al (2004) [15] Proven IgE- mediated NR United States 32–91 10 Imipenem or meropenem 0 0 0 1 1 Lager et al (2009) [12] Proven IgE- mediated NR United States >18 7 Imipenem, meropenem, or ertapenem 0 0 0 0 0 Patriarca et al (1999) [6] Proven IgE- mediated Negative Italy 23–60 3 Imipenem 0 0 0 0 0 Gorman et al (2003) [18] Proven IgE- mediated Positive Canada 40 1 a Imipenem 0 0 1 0 1 Romano et al (2007) [10] Suspected IgE- mediated Positive Italy 14–83 35 Meropenem 0 0 0 0 0 Romano et al (2006, 2007 "
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    ABSTRACT: Background: Cross-reactivity between penicillins or cephalosporins and carbapenems is anticipated as all have a beta lactam ring. However, the true incidence of immunoglobulin (Ig)E-mediated cross-reactivity is not known. Methods: A systematic review was conducted to collect and combine all published data on children and adults reported to have a clinical history of IgE-mediated hypersensitivity to a penicillin and/or cephalosporin who were subsequently given a carbapenem. Reactions were classified as proven, suspected, or possible IgE-mediated and non-IgE-mediated. Results: Ten studies and 12 case reports describing 854 participants fit the study criteria. For patients with previous proven, suspected, or possible IgE-mediated penicillin reactions (N = 838), the incidence of any type of suspected hypersensitivity reaction to a carbapenem was 36/838 (4.3%; 95% confidence interval [CI], 3.1%-5.9%) and the incidence of proven (1/838), suspected (0/838), or possible (19/838) IgE-mediated reactions was 20/838 (2.4%; 95% CI, 1.6%-3.7%). Of the subset of patients with positive penicillin skin tests (n = 295), only 1 had a hypersensitivity reaction (0.3%; 95% CI, .06%-1.9%), and this was a possible IgE-mediated reaction. For patients with previous proven, suspected, or possible IgE-mediated cephalosporin reactions (N = 12), the incidence of any type of hypersensitivity reaction to a carbapenem was 3/12 (25%); this included 2 non-IgE-mediated reactions and 1 possible IgE-mediated reaction. Conclusions: The cross-reactivity between penicillins and carbapenems for IgE-mediated reactions is very low, but caution is still advised. Cross-reactivity rates may be higher between cephalosporins and carbapenems; however, minimal data are available.
    Preview · Article · Jul 2014 · Clinical Infectious Diseases
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    • "On the other hand, patients who are truly allergic to aztreonam can safely receive a β-lactam, except ceftazidime. Both, meropenem and imipenem are well tolerated in penicillin skin-test-positive patients who have a negative skin test to imipenem.48 However, patients with a history of penicillin allergy with a positive skin test to penicillin who require imipenem should receive it by graded challenge. "
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    ABSTRACT: Anaphylaxis is an increasingly prevalent problem in westernized countries. Therefore, it is of utmost importance that the increasing numbers of patients at risk for anaphylaxis receive proper education on the etiology and risk factors as well as appropriate treatment of anaphylaxis with epinephrine. The physician's role is crucial in order to educate the patients and care takers on effective measures to prevent anaphylaxis and empower them to take charge of early recognition and proper management of an anaphylactic reaction to prevent poor outcomes. This review summarizes the clinical presentation, triggers, avoidance, and management of anaphylaxis.
    Full-text · Article · Jul 2014 · Journal of Asthma and Allergy
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    ABSTRACT: Veterinary antibiotics have been widely used for some decades. Although these substances are developed to perform a biological effect, little attention has been given to the presence of these pharmaceuticals in the environment, namely in aquatic systems. Frequent use of antibiotics raises concerns related to direct contamination of water and increase in antibiotic resistance of microorganisms. In aquatic environment, antibiotics can dissolve in the water and might be transferred to organisms due to bioaccumulation and biomagnification processes, affecting non-target organisms. One group of antibiotics largely used to combat infections caused by susceptible bacteria is the penicillin group. The present work addresses an important review on the occurrence, fate and effects of amoxicillin, the most used antibiotic within the β-lactams class, in aquatic systems. It brings up important questions, regarding the uncertainties related to the behavior of amoxicillin in aquatic systems as well as the risks associated with its occurrence.
    No preview · Chapter · Oct 2013
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