Brief communication: tolerability of meropenem in patients with IgE-mediated hypersensitivity to penicillins.

Abstract:

BACKGROUND:Although clinicians avoid giving meropenem to patients with penicillin allergy because of potential cross-reactivity, the rate of cross-reactivity between penicillins and meropenem has not been prospectively determined. OBJECTIVE:To assess the tolerability of meropenem in patients with documented penicillin allergy. DESIGN:Prospective skin testing and antibiotic challenge. SETTING:Allergy units of 2 Italian medical centers. PATIENTS:104 consecutive participants with immediate hypersensitivity reactions to penicillins and positive skin test results to at least 1 penicillin reagent. MEASUREMENTS:Skin tests to meropenem and, if results were negative, challenges with escalating doses of meropenem. RESULTS:One participant (0.9% [95% CI, 0.02% to 5.2%]) had a positive intradermal test result to meropenem. The remaining 103 participants with negative skin test results to meropenem tolerated escalating dose challenges. LIMITATION:Challenges were not followed by therapeutic courses. CONCLUSIONS:These data indicate a low rate of cross-reactivity between penicillins and meropenem. Therefore, the practice of avoiding meropenem therapy in penicillin-allergic patients should be reconsidered. In patients who especially require meropenem treatment, the authors recommend pretreatment skin tests because negative results indicate tolerability.

journal_name

Ann Intern Med

authors

Romano A,Viola M,Guéant-Rodriguez RM,Gaeta F,Valluzzi R,Guéant JL

doi

10.7326/0003-4819-146-4-200702200-00005

subject

Has Abstract

pub_date

2007-02-20 00:00:00

pages

266-9

issue

4

eissn

0003-4819

issn

1539-3704

pii

146/4/266

journal_volume

146

pub_type

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