CRITICALCARENOW
CRITICALCARENOW - By Rachel Rafeq - April 15, 2021
“The Debrief
- The rate of true IgE-mediated reactions to beta-lactams is 0.001%- 0.0005%.
- The most common beta-lactam reaction is a maculopapular rash which is not a true IgE mediated reaction.
- 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.
- Cross-reactivity between beta-lactams is dependent on the R1 side chain of the chemical structure.
- Identical R1 side chain: true cross-reactivity is likely and an alternative agent may be considered.
- Similar R1 side chain: use clinical judgment to determine if the reaction should be challenged.
- Different R1 side chain:, cross-reactivity is unlikely and beta-lactam use may be appropriate.”