ID:IOTS - Infectious Disease Insight Of Two Specialists 13. Penicillin Allergy (or not)
Dec 1, 2021
Dive into the intriguing world of penicillin allergies and the misconceptions that surround them. The discussion sheds light on the different types of hypersensitivity reactions and their impact on treatment options. Mislabeling allergies can lead to significant patient care challenges, but a new scoring system, PenFast, offers a way to assess risks effectively. Hear about the importance of accurate communication in the de-labeling process and how it can optimize antibiotic use, enhancing overall health outcomes.
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Incorrect Labels Harm Patients
- Penicillin allergy labels cause measurable harm by forcing use of inferior antibiotics and increasing complications.
- Removing incorrect labels improves outcomes like reduced C. difficile and shorter hospital stays.
How IgE Drives Acute Reactions
- Most immediate allergic reactions to drugs are type 1 IgE-mediated responses causing histamine release.
- IgE on mast cells/basophils cross-links and triggers reactions from rash to anaphylaxis.
Reported Vs True Allergy Rates
- Self-reported penicillin allergy is common but true allergy is rare: ~10% report it, ~10% of those truly allergic.
- Only ~1% of inpatients have severe true penicillin allergy.