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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Piperacillin-Tazobactam Hypersensitivity: A Large, Multicenter Analysis.

Rosamund Sara Casimir-Brown1, Lucinda Kennard2, Oyindamola Stephanie Kayode2

  • 1University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.

The Journal of Allergy and Clinical Immunology. in Practice
|January 14, 2021
PubMed
Summary
This summary is machine-generated.

Piperacillin-tazobactam hypersensitivity reactions occur in 55% of suspected cases, affecting both immediate and nonimmediate types. Most patients with piperacillin-tazobactam allergy can tolerate other penicillins, with some showing isolated tazobactam sensitivity.

Keywords:
AnaphylaxisBeta-lactamDrug allergyDrug provocation testImmediate hypersensitivityNonimmediate hypersensitivityPenicillinsPiperacillinSkin prick testTazobactam

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Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity
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Area of Science:

  • Allergy and Immunology
  • Pharmacology
  • Infectious Diseases

Background:

  • Piperacillin/tazobactam is a broad-spectrum penicillin antibiotic.
  • Hypersensitivity reactions to piperacillin/tazobactam are less common than with other penicillins, except in cystic fibrosis patients.

Purpose of the Study:

  • To clinically characterize a cohort of patients with suspected piperacillin-tazobactam hypersensitivity.
  • To investigate the diagnostic patterns and management of these hypersensitivity reactions.

Main Methods:

  • Retrospective analysis of 87 patients across 5 European allergy centers.
  • Utilized skin prick testing, intradermal testing, and drug provocation tests with various beta-lactams.
  • Employed a multistep protocol based on risk assessment for diagnosis.

Main Results:

  • 55% of patients were diagnosed with piperacillin-tazobactam hypersensitivity.
  • Immediate and nonimmediate hypersensitivity reactions were observed with similar frequency.
  • Cystic fibrosis patients predominantly showed nonimmediate hypersensitivity; 1/3 of patients had cross-sensitization to other penicillins.

Conclusions:

  • Piperacillin-tazobactam hypersensitivity presents with both immediate and nonimmediate reactions.
  • The majority of patients exhibit selective sensitization and tolerate other penicillins.
  • A subset of patients may have isolated allergy to the beta-lactamase inhibitor, tazobactam.