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Intravenous desensitization to beta-lactam antibiotics
The Journal of Allergy and Clinical Immunology
|September 1, 1987
Summary
Rapid intravenous desensitization safely treats patients with penicillin allergy and hypersensitivity. This effective method allows necessary beta-lactam antibiotic use for severe infections without immediate allergic reactions.
Area of Science:
- Allergy and Immunology
- Infectious Diseases
- Pharmacology
Background:
- Penicillin (PCN) allergy is common, complicating treatment of serious bacterial infections requiring beta-lactam antibiotics.
- Skin testing is crucial for confirming PCN hypersensitivity in patients with an allergy history.
Purpose of the Study:
- To review the safety and efficacy of rapid intravenous desensitization in patients with confirmed hypersensitivity to beta-lactam antibiotics.
- To evaluate the desensitization technique for patients requiring beta-lactam therapy.
Main Methods:
- Skin testing (prick and intradermal) with various penicillin antigens was performed.
- Rapid intravenous desensitization was conducted in an intensive care unit setting using a buret technique.
- The technique was adapted for various beta-lactam antibiotics.
Main Results:
- Fifteen desensitizations in 12 patients showed no immediate allergic reactions.
- One patient experienced a delayed pruritic rash and angioedema.
- A second patient developed a serum sickness-like illness, managed with corticosteroids.
Conclusions:
- Rapid intravenous desensitization is a safe and effective method for patients with documented beta-lactam hypersensitivity.
- This technique enables the use of essential beta-lactam antibiotics in high-risk patients.
- Delayed reactions can occur but are generally manageable without discontinuing therapy.
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