PMID- 36036421
OWN - NLM
STAT- MEDLINE
DCOM- 20221103
LR  - 20230111
IS  - 1531-698X (Electronic)
IS  - 1040-8703 (Linking)
VI  - 34
IP  - 6
DP  - 2022 Dec 1
TI  - Advances in immunoglobulin E mediated antibiotic allergy.
PG  - 609-615
LID - 10.1097/MOP.0000000000001171 [doi]
AB  - PURPOSE OF REVIEW: The purpose of this review is to identify recent advances in 
      our understanding and management of immunoglobulin E (IgE)-mediated antibiotic 
      allergy. RECENT FINDINGS: Antibiotics remain a leading cause of fatal anaphylaxis 
      reported to the FDA. However, recent advances have defined the features of adult 
      and pediatric patients without true IgE-mediated allergy or any mechanism of 
      anaphylaxis when tested. This has created opportunities to use direct challenges 
      to disprove these allergies at the point-of-care and improves antibiotic 
      stewardship. Additional advances have highlighted cross-reactive structural 
      considerations within classes of drugs, in particular the R1 side-chain of 
      cephalosporins, that appear to drive true immune-mediated cross-reactivity. 
      Further advances in risk-based approaches to skin testing, phenotyping, and 
      re-exposure challenges are needed to standardize antibiotic allergy evaluation. 
      SUMMARY: Recent advances in defining true IgE-mediated drug allergy have helped 
      to identify patients unlikely to be skin-test positive. In turn, this has 
      identified patients who can skip skin testing and proceed to direct ingestion 
      challenge using history risk-based approaches. The ability to identify the small 
      number of patients with true IgE-mediated allergy and study their natural history 
      over time, as well as the vast majority without true allergy will facilitate 
      important and novel mechanistic discoveries.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Rukasin, Christine R F
AU  - Rukasin CRF
AD  - Division of Pulmonary, Phoenix Children's Hospital.
AD  - Department of Child Health, University of Arizona College of Medicine-Phoenix.
AD  - Division of Allergic Diseases, Mayo Clinic Arizona, Scottsdale.
FAU - Phillips, Elizabeth J
AU  - Phillips EJ
AD  - Division of Infectious Diseases, Department of Medicine, Vanderbilt University 
      Medical Center.
AD  - Department of Pharmacology, Vanderbilt University School of Medicine.
AD  - Department of Pathology, Microbiology and Immunology, Vanderbilt School of 
      Medicine, Nashville, Tennessee, USA.
AD  - Institute for Immunology & Infectious Diseases, Murdoch University, Murdoch, 
      Western Australia, Australia.
FAU - Stone, Cosby A Jr
AU  - Stone CA Jr
AD  - Division of Allergy, Pulmonary, Critical Care Medicine, Department of Medicine, 
      Vanderbilt University Medical Center, Nashville, Tennessee, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20220829
PL  - United States
TA  - Curr Opin Pediatr
JT  - Current opinion in pediatrics
JID - 9000850
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Child
MH  - Immunoglobulin E
MH  - *Anaphylaxis/drug therapy
MH  - *Drug Hypersensitivity/complications/drug therapy
MH  - Skin Tests
MH  - Anti-Bacterial Agents/therapeutic use
EDAT- 2022/08/30 06:00
MHDA- 2022/11/04 06:00
CRDT- 2022/08/29 07:02
PHST- 2022/08/30 06:00 [pubmed]
PHST- 2022/11/04 06:00 [medline]
PHST- 2022/08/29 07:02 [entrez]
AID - 00008480-202212000-00014 [pii]
AID - 10.1097/MOP.0000000000001171 [doi]
PST - ppublish
SO  - Curr Opin Pediatr. 2022 Dec 1;34(6):609-615. doi: 10.1097/MOP.0000000000001171. 
      Epub 2022 Aug 29.