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Brief communication: tolerability of meropenem in patients with IgE-mediated hypersensitivity to penicillins

Antonino Romano1, Marinella Viola, Rosa-Maria Guéant-Rodriguez

  • 1Università Cattolica del Sacro Cuore, Complesso Integrato Columbus, Rome, Italy. antoninoromano@h-columbus.it

Annals of Internal Medicine
|February 21, 2007
PubMed
Abstract

Insights

Meropenem cross-reactivity in penicillin-allergic patients is low. Skin testing can help determine meropenem tolerability in these individuals, suggesting reconsideration of routine avoidance.

Area of Science:

  • Clinical Allergy and Immunology
  • Infectious Diseases
  • Pharmacology

Background:

  • Clinicians often avoid meropenem in penicillin-allergic patients due to theoretical cross-reactivity.
  • Prospective data on penicillin-meropenem cross-reactivity rates are limited.

Purpose of the Study:

  • To prospectively evaluate meropenem tolerability in patients with a documented penicillin allergy.
  • To determine the rate of cross-reactivity between penicillins and meropenem.

Main Methods:

  • Prospective study involving 104 patients with immediate penicillin hypersensitivity.
  • Utilized skin testing with meropenem, followed by graded dose challenges for negative skin test responders.
  • Conducted at allergy units in two Italian medical centers.

Main Results:

  • Only one participant (0.9%) showed a positive skin test to meropenem.
  • The remaining 103 participants with negative skin tests tolerated escalating doses of meropenem.
  • No therapeutic courses followed the challenges (study limitation).

Conclusions:

  • The study demonstrates a low rate of cross-reactivity between penicillins and meropenem.
  • Routine avoidance of meropenem in penicillin-allergic patients may not be necessary.
  • Pretreatment skin testing with meropenem is recommended for penicillin-allergic patients requiring meropenem therapy.

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