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Antibiotic allergy

Radoslaw Jaworski, Andrzej Kansy, Katarzyna Dzierzanowska-Fangrat, Bohdan Maruszewski
BACKGROUND: Prophylactic antibiotic therapy is given routinely in the peri-operative period to prevent surgical site infection. However, in pediatric cardiac surgery, an optimal schedule has not been defined. Pediatric recommendations follow the guidelines for adults, which might be improper because of the inherent challenges in pediatric research and the heterogeneity of the population. Implementation of an effective prophylaxis protocol is needed for children undergoing cardiac surgery, especially in view of worldwide antibiotic overuse and the development of drug resistance...
February 14, 2019: Surgical Infections
Erminia Ridolo, Irene Martignago, Irene Pellicelli, Cristoforo Incorvaia
Background: Up to one-third of the patients suffering from eosinophilic esophagitis (EoE) present a refractory form, as defined by nonresponsiveness in clinical, endoscopic, or histological assessment after first-line therapy. Several studies recently investigated which factors can influence the development of this disease, but very few analyzed the factors underlying refractory EoE. Methods: Medical charts of patients affected by EoE were retrospectively evaluated...
2019: Gastroenterology Research and Practice
Tanya du Plessis, Genevieve Walls, Anthony Jordan, David J Holland
Background: Inaccurate allergy labelling results in inappropriate antimicrobial management of the patient, which may affect clinical outcome, increase the risk of adverse events and increase costs. Inappropriate use of alternative antibiotics has implications for antimicrobial stewardship programmes and microbial resistance. Methods: All adult inpatients labelled as penicillin allergic were identified and screened for eligibility by the study pharmacist. An accurate allergy and medication history was taken...
February 6, 2019: Journal of Antimicrobial Chemotherapy
Lucio Capurso
Lactobacillus rhamnosus GG (LGG) was the first strain belonging to the genus Lactobacillus to be patented in 1989 thanks to its ability to survive and to proliferate at gastric acid pH and in medium containing bile, and to adhere to enterocytes. Furthermore LGG is able to produces both a biofilm that can mechanically protect the mucosa, and different soluble factors beneficial to the gut by enhancing intestinal crypt survival, diminishing apoptosis of the intestinal epithelium, and preserving cytoskeletal integrity...
March 2019: Journal of Clinical Gastroenterology
Liza Bronner Murrison, Eric B Brandt, Jocelyn Biagini Myers, Gurjit K Khurana Hershey
Environmental exposures interplay with human host factors to promote the development and progression of allergic diseases. The worldwide prevalence of allergic disease is rising as a result of complex gene-environment interactions that shape the immune system and host response. Research shows an association between the rise of allergic diseases and increasingly modern Westernized lifestyles, which are characterized by increased urbanization, time spent indoors, and antibiotic usage. These environmental changes result in increased exposure to air and traffic pollution, fungi, infectious agents, tobacco smoke, and other early-life and lifelong risk factors for the development and exacerbation of asthma and allergic diseases...
February 11, 2019: Journal of Clinical Investigation
Sarah Milliken, Ruridh M Allen, Ronald F Lamont
The use of antibiotics prenatally, during pregnancy, or neonatally may have adverse effects on the neonatal gut microbiome, and adversely affect the development of the infant immune system, leading to the development of childhood atopy, asthma, allergy and obesity. Areas covered: We reviewed new evidence about vaginal eubiosis and dysbiosis from molecular-based, cultivation-independent techniques, and how this affects the neonatal gut microbiome and early development of the immune system in infants. We have considered the association between maternal use of antibiotics and the potentially beneficial role of vitamin D in the development of atopy, asthma, allergy and obesity...
February 11, 2019: Expert Opinion on Drug Safety
Stefanie Metzler, Remo Frei, Elisabeth Schmaußer-Hechfellner, Erika von Mutius, Juha Pekkanen, Anne M Karvonen, Pirkka V Kirjavainen, Jean-Charles Dalphin, Amandine Divaret-Chauveau, Josef Riedler, Roger Lauener, Caroline Roduit
BACKGROUND: Allergies are a serious public health issue and prevalences are rising worldwide. The role of antibiotics in the development of allergies has repeatedly been discussed, as results remain inconsistent. The aim of this study was to investigate the association between pre- & postnatal antibiotic exposure and subsequent development of allergies (atopic dermatitis, food allergy, asthma, atopic sensitization and allergic rhinitis). METHODS: A total of 1080 children who participated in a European birth cohort study (PASTURE) were included in this analysis...
February 8, 2019: Pediatric Allergy and Immunology
Jacob J Patz, Melissa C Helm, Rana M Higgins, Matthew I Goldblatt, Jon C Gould, Tammy L Kindel
BACKGROUND: Recent studies have suggested that potential aberrant alterations in the gastrointestinal microbiome contribute to the development of cardiovascular disease, specifically hypertension. Bariatric surgery produces significant sustained weight loss and hypertension resolution likely through multiple mechanisms which includes beneficial changes in the gut microbiome. We hypothesized that the type of prophylactic antibiotic given for bariatric surgery could impact the resolution rate of hypertension by altering the post-operative gastrointestinal microflora...
February 7, 2019: Surgical Endoscopy
Kimberly G Blumenthal, Anna R Wolfson, Yu Li, Claire M Seguin, Neelam A Phadke, Aleena Banerji, Elizabeth Mort
BACKGROUND: The epidemiology of hospital adverse reactions (ARs), particularly allergic reactions, or hypersensitivity reactions (HSRs), is poorly defined. To determine priorities for allergy safety in healthcare, we identified and described safety reports of allergic reactions. METHODS: We searched the safety report database of a large academic medical center from April 2006 to March 2016 using 101 complete, truncated, and/or misspelled key words related to allergic symptoms, treatments, and culprits (e...
January 31, 2019: Journal of Patient Safety
Merve Bacanli, Nurşen Başaran
Veterinary medicines, especially antibiotics, are among the most important components related to animal feed production. Generally, the main use of antibiotics in animals is for the treatment and prevention of diseases and growth promotion. Antibiotic usage in animals may result antibiotic residues in foodstuffs such as milk, egg and meat. These residues may cause various side effects such as transfer of antibiotic resistant bacteria to humans, immunopathological effects, allergy, mutagenicity, nephropathy (gentamicin), hepatotoxicity, reproductive disorders, bone marrow toxicity (chloramphenicol) and even carcinogenicity (sulphamethazine, oxytetracycline, furazolidone)...
January 30, 2019: Food and Chemical Toxicology
Bernhardt Sachs, Diana Dubrall, Wilma Fischer-Barth, Matthias Schmid, Julia Stingl
PURPOSE: The main objective of this study was to analyze validated cases of drug-induced anaphylactic reactions in children with regard to incriminated drugs, clinical characteristics, and associated factors. A further objective was to compare differences in incriminated drugs and characteristics between validated cases and a reference excluding anaphylactic reaction cases (basic dataset). METHODS: Spontaneous reports of anaphylactic reactions in children (0-17 years) registered between January 2000 to December 2016 were extracted from the adverse drug reaction database of the German Federal Institute for Drugs and Medical Devices...
January 31, 2019: Pharmacoepidemiology and Drug Safety
David Vyles, Rakesh Mistry, Viday Heffner, Patrick Drayna, Asriani Chiu, Alexis Visotcky, Raphael Fraser, David C Brousseau
BACKGROUND: PEM and PCP providers are the most likely physicians to initially label a child as penicillin allergic. Differences in knowledge and management of reported penicillin allergy between these two groups has not been well characterized. METHODS: A cross-sectional 20-question survey was administered to PEM and PCP's to ascertain differential knowledge and management of penicillin allergy. Knowledge regarding high and low-risk symptoms for true allergy and extent of history taking regarding allergy were compared between the two groups using t-tests, Chi-square and Wilcoxon tests...
January 28, 2019: Academic Pediatrics
Christopher M Bland, P Brandon Bookstaver, Nicole C Griffith, Emily L Heil, Bruce M Jones, Julie Ann Justo, Mary L Staicu, Nicholas P Torney, Geoffrey C Wall
Purpose: The purpose of this article is to offer practical guidance for pharmacists to successfully implement penicillin allergy skin testing (PAST). Summary: Less than 10% of patients labeled as having a penicillin allergy are confirmed as present upon skin testing. This labeling results in use of alternative antibiotics and thus unwanted adverse consequences including potentiated antimicrobial resistance, increased costs, and worse clinical outcomes. Stewardship guidelines recommend PAST to enhance use of first-line agents; however, this was a weak recommendation with low-quality evidence...
January 25, 2019: American Journal of Health-system Pharmacy: AJHP
Elizabeth W Covington, Beth Jobson Baldwin, Emily Warren
BACKGROUND: Patients with reported β-lactam allergies often receive broad-spectrum antimicrobials and have been shown to experience a variety of negative health consequences, such as increased mortality, costs, readmission, and adverse reactions. Current literature focuses on β-lactam allergy skin testing but lacks evidence on β-lactam allergy interviews (BLAI) when skin testing is unavailable. OBJECTIVE: This study aimed to test the impact of a pharmacy-led BLAI on duration of fluoroquinolones at a community hospital...
January 28, 2019: Annals of Pharmacotherapy
Carlo Yuson, Kimti Kumar, Adriana Le, Aida Ahmadie, Tatjana Banovic, Robert Heddle, Frank Kette, William Smith, Pravin Hissaria
BACKGROUND: Patients who suffer from acute IgE-mediated allergy to a cephalosporin antibiotic are frequently assumed to be at high risk of allergy to other cephalosporins and penicillins. OBJECTIVE: To define cross-reactivity patterns in patients with confirmed allergy to a cephalosporin. METHODS: Subjects presenting with a history of immediate allergy to a cephalosporin-family antibiotic between March 2009 to July 2017 were investigated with specific IgE (sIgE) testing to penicillin, amoxicillin and cefaclor, followed by skin prick testing (SPT), intradermal testing (IDT) and drug provocation testing (DPT) with a panel of penicillins and cephalosporins...
January 22, 2019: Internal Medicine Journal
David In Chull Hong
Drug desensitization is procedure by which patients can be tolerized to medications that have previously induced hypersensitivity reactions. Initially used in treating hypersensitivity reactions to antibiotics, desensitization is now frequently used in the setting of allergy to chemotherapy drugs and biologics, thus widening the clinical applicability of this procedure which has been proven to be quite safe and effective in improving clinical outcomes, mainly by allowing patients to remain on preferred first-line therapy...
February 2019: Yonsei Medical Journal
Erica S Shenoy, Eric Macy, Theresa Rowe, Kimberly G Blumenthal
Importance: β-Lactam antibiotics are among the safest and most effective antibiotics. Many patients report allergies to these drugs that limit their use, resulting in the use of broad-spectrum antibiotics that increase the risk for antimicrobial resistance and adverse events. Observations: Approximately 10% of the US population has reported allergies to the β-lactam agent penicillin, with higher rates reported by older and hospitalized patients. Although many patients report that they are allergic to penicillin, clinically significant IgE-mediated or T lymphocyte-mediated penicillin hypersensitivity is uncommon (<5%)...
January 15, 2019: JAMA: the Journal of the American Medical Association
Taylor Feehley, Catherine H Plunkett, Riyue Bao, Sung Min Choi Hong, Elliot Culleen, Pedro Belda-Ferre, Evelyn Campbell, Rosita Aitoro, Rita Nocerino, Lorella Paparo, Jorge Andrade, Dionysios A Antonopoulos, Roberto Berni Canani, Cathryn R Nagler
There has been a striking generational increase in life-threatening food allergies in Westernized societies1,2 . One hypothesis to explain this rising prevalence is that twenty-first century lifestyle practices, including misuse of antibiotics, dietary changes, and higher rates of Caesarean birth and formula feeding have altered intestinal bacterial communities; early-life alterations may be particularly detrimental3,4 . To better understand how commensal bacteria regulate food allergy in humans, we colonized germ-free mice with feces from healthy or cow's milk allergic (CMA) infants5 ...
January 14, 2019: Nature Medicine
E Untersmayr, H J Bax, C Bergmann, R Bianchini, W Cozen, H J Gould, K Hartmann, D H Josephs, F Levi-Schaffer, M L Penichet, L O'Mahony, A Poli, F Redegeld, F Roth-Walter, M C Turner, L Vangelista, S N Karagiannis, E Jensen-Jarolim
The microbiota can play important roles in the development of human immunity and the establishment of immune homeostasis. Lifestyle factors including diet, hygiene, and exposure to viruses or bacteria, and medical interventions with antibiotics or anti-ulcer medications, regulate phylogenetic variability and the quality of cross-talk between innate and adaptive immune cells via mucosal and skin epithelia. More recently, microbiota and their composition have been linked to protective effects for health. Imbalance, however, has been linked to immune-related diseases such as allergy and cancer, characterized by impaired, or exaggerated immune tolerance, respectively...
January 12, 2019: Allergy
Marjolein Wentink, Daphne Peeters, Mirjam van der Burg, Clementien Vermont, Liesbeth Duijts, Gertjan J Driessen
A 3-year-old girl was referred to a pediatric pulmonologist for dyspnea and recurrent upper respiratory tract infections (RTIs). The patient was born full term to unrelated Dutch parents after an uneventful pregnancy and birth. The year before presentation, she had suffered from pneumonia and > 10 upper RTIs. Apart from the recurrent RTIs, which started in infancy, her medical history was not significant and did not include allergies or eczema. An adenotonsillectomy was performed at the age of 2 years, and she was treated with multiple antibiotic regimens and inhalation therapy with salbutamol and corticosteroids, with no relief of symptoms...
January 2019: Chest
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