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Vol 25. no 4
December 2020

What is penicillin allergy delabeling? New concepts in the diagnosis of hypersensitivity to beta-lactam antibiotics (summary)
Karolina Frachowicz, Aleksandra Wardzyńska, Marek L. Kowalski
Allergy to β-lactam (βL) antibiotics is one of the most commonly reported drug hypersensitivity, but only in a small percentage of patients, using the available diagnostic methods. Medical history is not a sufficient diagnostic tool for βL hypersensitivity. Confirmation or exclusion of β-lactam allergy depending on the presumed reaction mechanism is based on skin tests (ST) or patch tests (PT). In a patient with known hypersensitivity to β-lactam antibiotics, the drug that caused the reaction should be avoided, but an alternative βL may be selected after appropriate diagnosis (usually with skin tests and provocation tests). For a patient with a βL hypersensitivity label, treatment options are limited. The cost of alternative antibiotics, extended hospital stay, and the need for readmission to hospital are all associated with increased costs for treating patients labeled as hypersensitive to βL. The diagnosis of hypersensitivity to βL, unverified and often made hastily, becomes a significant problem affecting not only the patient, but also the health care system. It is up to allergists to pay more attention to the problem of unnecessary diagnoses of hypersensitivity to βL and to implement delabeling in patient.
Keywords: drug hypersensitivity, antibiotic allery, penicillin, β-lactams, delabeling
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