PMID- 25752938
OWN - NLM
STAT- MEDLINE
DCOM- 20151006
LR  - 20151119
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 125
IP  - 8
DP  - 2015 Aug
TI  - Cephalosporin use in penicillin-allergic patients: a survey of otolaryngologists 
      and literature review.
PG  - 1822-6
LID - 10.1002/lary.25227 [doi]
AB  - OBJECTIVES/HYPOTHESIS: This study investigated the differences between the 
      standard guidelines and the practice patterns of otolaryngologists in managing 
      "penicillin-allergic" patients. A major goal was to identify factors influencing 
      an otolaryngologist's choice of antibiotic. STUDY DESIGN: Cross-sectional survey. 
      METHODS: Four hundred seventy members of the American Society of Pediatric 
      Otolaryngologists (ASPO) and 150 general otolaryngologists from the Florida 
      Society of Otolaryngology (FSO) were surveyed. RESULTS: Ninety-six ASPO members 
      (20.4%) and 22 members of FSO (14.6%) responded. When asked about the management 
      of a pediatric patient with acute otitis media and a history of a nonsevere 
      immunoglobulin E (IgE)-mediated amoxicillin allergy, 54% of ASPO respondents 
      indicated they would initiate guideline-recommended cefdinir, whereas only 27% of 
      FSO respondents chose cefdinir (P = .02). Otolaryngologists who are fellowship 
      trained in pediatrics or have pediatric-focused practices were significantly more 
      likely to prescribe cefdinir. Overall, 57% of respondents indicated that they 
      were familiar with the literature regarding the cross-reactivity of beta-lactams, 
      but only 25% of respondents felt that they could easily differentiate a 
      potentially life-threatening IgE-mediated allergy from a non-IgE-mediated drug 
      intolerance. CONCLUSIONS: The data show differences between the current 
      recommendations and the behavior of otolaryngologists. Pediatric 
      otolaryngologists were more familiar with the guideline-recommended therapy, 
      likely from their frequent exposure to patients requiring a beta-lactam. 
      Nevertheless, most otolaryngologists could benefit from increased awareness of 
      the current literature. Patients may be receiving less than optimal medication 
      management due to a misidentification of those at risk of life- threatening 
      allergic cross-reactions. LEVEL OF EVIDENCE: NA
CI  - (c) 2015 The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Persky, Michael J
AU  - Persky MJ
AD  - Department of Otolaryngology-Head and Neck Surgery, New York University School of 
      Medicine, New York, New York, U.S.A.
FAU - Roof, Scott A
AU  - Roof SA
AD  - Department of Otolaryngology-Head and Neck Surgery, New York University School of 
      Medicine, New York, New York, U.S.A.
FAU - Fang, Yixin
AU  - Fang Y
AD  - Department of Population Health, New York University School of Medicine, New 
      York, New York, U.S.A.
AD  - Department of Environmental Medicine, New York University School of Medicine, New 
      York, New York, U.S.A.
FAU - Jethanamest, Daniel
AU  - Jethanamest D
AD  - Department of Otolaryngology-Head and Neck Surgery, New York University School of 
      Medicine, New York, New York, U.S.A.
FAU - April, Max M
AU  - April MM
AD  - Department of Otolaryngology-Head and Neck Surgery, New York University School of 
      Medicine, New York, New York, U.S.A.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20150305
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Cephalosporins)
RN  - 0 (Penicillins)
SB  - IM
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Cephalosporins/*therapeutic use
MH  - *Drug Hypersensitivity
MH  - Humans
MH  - Otitis Media/*drug therapy
MH  - Otolaryngology/*statistics & numerical data
MH  - Penicillins/*adverse effects
MH  - *Surveys and Questionnaires
OTO - NOTNLM
OT  - Allergy
OT  - antibiotic
OT  - clinical practice guidelines
OT  - evidence-based medicine
OT  - immunology
OT  - pen-allergic
OT  - penicillin
EDAT- 2015/03/11 06:00
MHDA- 2015/10/07 06:00
CRDT- 2015/03/11 06:00
PHST- 2015/02/03 00:00 [accepted]
PHST- 2015/03/11 06:00 [entrez]
PHST- 2015/03/11 06:00 [pubmed]
PHST- 2015/10/07 06:00 [medline]
AID - 10.1002/lary.25227 [doi]
PST - ppublish
SO  - Laryngoscope. 2015 Aug;125(8):1822-6. doi: 10.1002/lary.25227. Epub 2015 Mar 5.