Antimicrobial Allergy Evaluation Tool
Penicillin and Beta-Lactam Allergy

Penicillin and Beta-Lactam Allergy

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SAH ASP has adopted the NB Provincial Health Authorities Anti-Infective Stewardship Committee Guideline. Paper version available here: Management of Penicillin and Beta-Lactam Allergy

Guideline content derived from: NB Provincial Health Authorities Anti-Infective Stewardship Committee. Management of Penicillin and Beta-Lactam Allergy. 09-2017

  1. Macy E and Ngor E. Recommendations for the Management of Beta-Lactam Intolerance. Clinic Rev Allerg Immunol 2014; 47:46-55
  2. Blondel-Hill and Fryters. B-Lactam Allergy. Bugs and Drugs: An antimicrobial/infectious disease reference. 2012:87-90.
  3. PL Detailed-document, Allergic Cross-reactivity Among Beta-lactam Antibiotics: An Update. Pharmacist’s Letter/Prescriber’s Letter. October 2013
  4. Terico AT and Gallagher JC. Beta-lactam allergy and cross-reactivity. J Pharm Pract. 2014 Dec;27(6):530-44.
  5. Pichichero, Michael E. A review of evidence supporting the American Academy of Pediatrics recommendations for prescribing cephalosporin antibiotics in penicillin allergic patients. Pediatrics. 2005(115):1048-55.
  6. DePestel DD, Benninger MS, Danziger L, LaPlante KL, May C, et al. Cephalosporin use in treatment of patients with penicillin allergies. J Am Pharm Assoc. 2008; 48:530-540
  7. Mirakian R, Leech SC, Krishna MT, Richter AG, Huber PAJ, et al. Management of allergy to penicllins and other beta-lactams. Clinical & Experimental Allergy 45:300-327
  8. Pichichero ME and Zagursky R. Penicillin and Cephalosporin Allergy. Ann Allergy Asthma Immunol 112(2014):404-412
  9. Lagacé-Wiens P. and Rubinstein E.. Adverse reactions to B-Lactam antimicrobials. Expert Opin. Drug Saf. 2012(11):381-99.
  10. Demoly, P., Kropf, R., Bircher, A. & Pichler, W.J. (1999). Drug hypersensitivity: questionnaire. Allergy, 54:999-1003.
  11. Salkind, A.R., Cuddy, P.G. & Foxworth, J.W. (2001). Is this patient allergic to penicillin? An evidence-based analysis of the likelihood of penicillin allergy. JAMA, 285(19): 2498-2505.
  12. Stokes, S. & Tankersle, M. (2011). HIV: Practical implications for the practicing allergist-immunologist. Ann Allergy Asthma Immunol, 107: 1-8.
  13. Aota, N. & Shiohara, T. (2009). Viral connection between drug rashes and autoimmune diseases: How autoimmune responses are generated after resolution of drug rashes. Autoimmunity Reviews, 8(6): 488-494.
  14. Tohyama, M. & Hashimoto, K. (2011). New aspects of drug-induced hypersensitivity syndrome. Journal of Dermatology, 38(3): 222-228.
  15. Napoli DC & Neeno TA. Anaphylaxis to Benzathine Penicillin G. Pediatr Asthma Allergy Immunol 2000;14(4):329-332
  16. Allergic Reactions to Long-Term Benzathine Penicillin Prophylaxis for Rheumatic Fever. International Rheumatic Fever Study Group. Lancet 1991 Jun 1; 337(8753):1308-10
  17. Idsoe O, GutheT, Willcox RR & De Weck AL. Nature and Extent of Penicillin Side-Reactions, with Particular Reference to Fatalities from Anaphylactic Shock. Bull. Wld Hlth Org. 1968;38:159-188
  18. Meyers BR. Comparative Toxicities of Third Generation Cephalosporins. Am J Med. 1985 Aug 9;79(2A):96-103.
  19. KelKar P.S. and Li J.T.C. Cephalosporin Allergy. N Engl J Med 2001; 345(11):804-809
  20. Macy E & Contreras R. Adverse Reactions Associated with Oral and Parenteral Use of Cephalosporins: A Retrospective Population-Based Analysis. J Allergy Clin Immunol 2015;135:745-752

Adapted from the Horizon Health Network Antimicrobial Stewardship Program