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Management of allergy to penicillins and other beta-lactams.

Authors
  • Mirakian, R1
  • Leech, S C
  • Krishna, M T
  • Richter, A G
  • Huber, P A J
  • Farooque, S
  • Khan, N
  • Pirmohamed, M
  • Clark, A T
  • Nasser, S M
  • 1 Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Type
Published Article
Journal
Clinical & Experimental Allergy
Publisher
Wiley (Blackwell Publishing)
Publication Date
Feb 01, 2015
Volume
45
Issue
2
Pages
300–327
Identifiers
DOI: 10.1111/cea.12468
PMID: 25623506
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The Standards of Care Committee of the British Society for Allergy and Clinical Immunology (BSACI) and an expert panel have prepared this guidance for the management of immediate and non-immediate allergic reactions to penicillins and other beta-lactams. The guideline is intended for UK specialists in both adult and paediatric allergy and for other clinicians practising allergy in secondary and tertiary care. The recommendations are evidence based, but where evidence is lacking, the panel reached consensus. During the development of the guideline, all BSACI members were consulted using a Web-based process and all comments carefully considered. Included in the guideline are epidemiology of allergic reactions to beta-lactams, molecular structure, formulations available in the UK and a description of known beta-lactam antigenic determinants. Sections on the value and limitations of clinical history, skin testing and laboratory investigations for both penicillins and cephalosporins are included. Cross-reactivity between penicillins and cephalosporins is discussed in detail. Recommendations on oral provocation and desensitization procedures have been made. Guidance for beta-lactam allergy in children is given in a separate section. An algorithm to help the clinician in the diagnosis of patients with a history of penicillin allergy has also been included. © 2015 John Wiley & Sons Ltd.

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