Guideline on diagnostic procedures for suspected hypersensitivity to beta-lactam antibiotics

• DOI: 10.1007/s40629-019-0100-8
• Publication Date: 2019-07-22T14:03:14Z
• Authors: Gerda Wurpts; Werner Aberer; Heinrich Dickel; Randolf Brehler; Thilo Jakob; Burkhard Kreft; Vera Mahler; Hans F. Merk; Norbert Mülleneisen; Hagen Ott; Wolfgang Pfützner; Stefani Röseler; Franziska Ruëff; Helmut Sitter; Cord Sunderkötter; Axel Trautmann; Regina Treudler; Bettina Wedi; Margitta Worm; Knut Brockow
• Keywords: Guideline; Drug allergy; Beta-lactam

This guideline on diagnostic procedures for suspected beta-lactam antibiotic (BLA) hypersensitivity was written by the German and Austrian professional associations allergology, Paul-Ehrlich Society Chemotherapy in a consensus procedure according to criteria of Association Scientific Medical Societies. BLA such as penicillins cephalosporins represent drug group that most frequently triggers allergies. However, frequency reports allergy patient histories clearly exceeds number confirmed cases. The large allergies has significant impact on, e.g., quality treatment received individual costs society whole. Allergies are based different immunological mechanisms often manifest maculopapular exanthema, well anaphylaxis; there also less frequent special clinical manifestations allergic reactions. All have ring. categorized into classes: penicillins, cephalosporins, carbapenems, monobactams, beta-lactamase inhibitors with chemical structures. Knowledge possible cross-reactivity is considerable significance. Whereas common ring occurs only small percentage all patients, due side chain similarities, aminopenicillins aminocephalosporins, even methoxyimino more common. overall picture complex its elucidation may require further research. Diagnostic used usually made up four components: history, laboratory diagnostics, skin testing (which particularly important), provocation testing. approach—even cases where need administer acute—is guided history risk–benefit ratio case. Here again, studies required extend present state knowledge. Performing urgently recommended not interests providing good medical care, but immense putative