Discover how emergency departments are revolutionizing patient care by safely challenging moderate, severe, and unknown beta-lactam allergies with full-dose treatments.
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Full-dose challenge of moderate, severe, and unknown beta-lactam allergies in the emergency department.
Anderson et al., Acad Emerg Med 2024
<!– DOI: 10.1111/acem.14893 //–>
https://doi.org/10.1111/acem.14893
This retrospective study, conducted from January 2021 to December 2022, evaluated the safety of administering full-dose beta-lactam antibiotics to emergency department (ED) patients with documented moderate, severe, or unknown beta-lactam allergies. The study involved 184 ED encounters where patients were given a full dose of a beta-lactam antibiotic without prior tolerance documentation. The findings revealed that only 2.7% of these patients experienced an allergic reaction, all of which were non-anaphylactic and limited to mild symptoms such as rash or itching. Notably, 98.9% of the challenges involved a cephalosporin, and in 86.4% of cases, beta-lactam treatment was continued. Additionally, 73.4% of patients had their allergy profiles updated based on the challenge outcome.
Significance: This study highlights the potential for safely challenging documented beta-lactam allergies in the ED setting, thereby avoiding unnecessary allergy testing and the use of less optimal antibiotic alternatives. This approach could significantly improve antibiotic stewardship and patient outcomes by enabling the use of first-line beta-lactam antibiotics in a larger portion of the patient population.