Risk stratification in beta-lactam allergy

AbstractPurpose of ReviewBeta-lactams (BLs) are among the most commonly prescribed and effective antibiotics. Given the fact that overdiagnosis of penicillin allergy constitutes a major public health problem by increasing health costs and contributing to overall antibiotic resistance, removing BL allergy label is crucial.Recent FindingsDelabeling penicillin allergy as an essential component of antimicrobial stewardship is a hot topic. Despite several clinical risk factors and genetic characteristics proposed to predict BL allergy, it is still unclear what exactly constitutes a risk. Recently, a great deal of interest has been focused in the design of risk stratification and implementing pathways in order to classify the risk based on the clinical history. Appropriate risk stratification is critical to ensure that high-risk patients are referred to allergy specialist for further diagnostic assessment, whereas direct drug provocation tests can be safely employed in low-risk patients.SummaryMany patients labeled as allergic to BLs are able to tolerate these drugs. The huge burden of penicillin allergy can be tackled by integrating risk-based and traditional testing strategies into antibiotic stewardship programs. Promising potential methods to accurately assess BL allergy risk will require collaborative multimodal approaches including risk stratification pathways with validated tools.
Source: Current Treatment Options in Allergy - Category: Allergy & Immunology Source Type: research