Related Experiment Video
Updated: Aug 25, 2025
Author Spotlight: Investigating the Key Factors of Obliterative Bronchiolitis After Lung Transplantation
Published on: November 10, 2023
Effects of reported beta-lactam allergies on pneumonia outcomes in lung transplant recipients
Andrew R Motzer1, Eric Holaday2, Peter Axelrod1
1Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.
Background:
The effects of reported beta-lactam allergies on clinical outcomes have been understudied in lung transplant recipients. We evaluated reported beta-lactam allergies on clinical outcomes in this population.
Methods:
A single-center retrospective cohort analysis was performed. One hundred and nine lung transplant recipients were identified and screened for a diagnosis of pneumonia. This cohort was divided into those with a reported beta-lactam allergy and those without a beta-lactam allergy. Antibiotic use was compared between groups. We also compared several clinical metrics, including rates of readmission, mortality, Clostridium difficile infection (CDI), allograft dysfunction, and isolation of carbapenem or fluoroquinolone non-susceptible organisms after treatment.
Results:
Of the 109 lung transplant recipients, 18 (16.5%) were identified as having a reported beta-lactam allergy. Patients with a beta-lactam allergy label (BLAL) were found to have decreased utilization of beta-lactams (p < .001) and a trend toward increased use of carbapenems (p = .062) and aztreonam (p = .080). BLAL patients were found to have higher rates of CDI (p = .049) but were not found to have increased readmissions, mortality, allograft dysfunction, or isolation of carbapenem or fluoroquinolone non-susceptible organisms. Patients without a BLAL were found to have higher rates of acute kidney injury (AKI) (p = .035).
Conclusions:
Lung transplant recipients with BLAL are more likely to develop CDI, possibly due to increased use of carbapenems. We also found that patients without beta-lactam allergy were more likely to develop AKI. A multicenter study with a larger sample size might clarify the individual contributions of mutually confounding clinical parameters.
Insights
Lung transplant recipients with a reported beta-lactam allergy (BLAL) face higher rates of Clostridium difficile infection (CDI). Patients without a BLAL showed increased acute kidney injury (AKI) risk.
Area of Science:
- Medical research
- Transplant immunology
- Infectious disease
Background:
- Beta-lactam allergies are common but their impact on lung transplant recipients is not well understood.
- Clinical outcomes in lung transplant recipients with reported beta-lactam allergies require further investigation.
Purpose of the Study:
- To evaluate the clinical outcomes associated with reported beta-lactam allergies in lung transplant recipients.
- To compare antibiotic utilization and key clinical metrics between lung transplant recipients with and without beta-lactam allergy labels.
Main Methods:
- A retrospective cohort study of 109 lung transplant recipients was conducted.
- Patients were categorized based on the presence or absence of a reported beta-lactam allergy.
- Antibiotic use, readmissions, mortality, Clostridium difficile infection (CDI), allograft dysfunction, and isolation of resistant organisms were compared.
Main Results:
- 16.5% of lung transplant recipients had a reported beta-lactam allergy.
- Patients with a beta-lactam allergy label (BLAL) showed decreased beta-lactam use and a trend toward increased carbapenem and aztreonam use.
- BLAL patients had higher CDI rates (p=0.049), while non-BLAL patients had higher acute kidney injury (AKI) rates (p=0.035).
Conclusions:
- Lung transplant recipients with BLAL are at increased risk for CDI, potentially linked to carbapenem use.
- Patients without a reported beta-lactam allergy demonstrated a higher incidence of AKI.
- Further multicenter research with larger cohorts is recommended to elucidate confounding clinical factors.
More Related Videos
09:17A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii
Published on: January 2, 2017
10:01Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation
Published on: July 10, 2012
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:16Kidney Transplant III: Nursing Management
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:28Kidney Transplant I: Introduction
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...