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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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Friday, April 16, 2021

Beta-Lactam Allergies

CRITICALCARENOW
CRITICALCARENOW - By Rachel Rafeq - April 15, 2021
“The Debrief 
  1. The rate of true IgE-mediated reactions to beta-lactams is 0.001%- 0.0005%. 
  2. The most common beta-lactam reaction is a maculopapular rash which is not a true IgE mediated reaction.
  3. Documented beta-lactam allergies should be reviewed to determine if a true allergy exists or if the allergy is a mislabel. Mislabeled allergies should be removed from the chart to prevent patients from being precluded from future beta-lactam therapy. 
  4. Cross-reactivity between beta-lactams is dependent on the R1 side chain of the chemical structure. 
  5. Identical R1 side chain: true cross-reactivity is likely and an alternative agent may be considered. 
  6. Similar R1 side chain: use clinical judgment to determine if the reaction should be challenged. 
  7. Different R1 side chain:, cross-reactivity is unlikely and beta-lactam use may be appropriate.”