The drug of concern is deemed irreplaceable
The drug of concern is more effective than available alternatives
The drug of concern is much safer than available alternatives
During the desensitization procedure, vital signs should be monitored closely and patients should be instructed to report symptoms of any potential hypersensitivity reaction
Click here to access the NB-ASC Desensitization Guidelines for more details; such as sample densitization orders and protocols.
Guideline content derived from: NB Provincial Health Authorities Anti-Infective Stewardship Committee. Antimicrobial Desensitization. 05-2019
Lagace-Wiens P, Rubinstein E. Adverse reactions to beta-lactam antimicrobials. Expert opinion on drug safety. 2012;11(3):381-399.
Solensky R. Allergy to beta-lactam antibiotics. J Allergy Clin Immunol. 2012;130(6):1442-1442 e1445.
Macy E, Schatz M, Lin C, Poon KY. The falling rate of positive penicillin skin tests from 1995 to 2007. The Permanente journal. 2009;13(2):12-18.
Borch JE, Andersen KE, Bindslev-Jensen C. The prevalence of suspected and challenge-verified penicillin allergy in a university hospital population. Basic & clinical pharmacology & toxicology. 2006;98(4):357-362.
Macy E, Ngor E. Recommendations for the management of beta-lactam intolerance. Clin Rev Allergy Immunol. 2014;47(1):46-55.
Solensky R. Drug desensitization. Immunology and allergy clinics of North America. 2004;24(3):425-443, vi.
Cernadas JR, Brockow K, Romano A, et al. General considerations on rapid desensitization for drug hypersensitivity - a consensus statement. Allergy. 2010;65(11):1357-1366.
Legendre DP, Muzny CA, Marshall GD, Swiatlo E. Antibiotic hypersensitivity reactions and approaches to desensitization. Clin Infect Dis. 2014;58(8):1140-1148.
Drug allergy: an updated practice parameter. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2010;105(4):259-273.
Pham MN, Ho HE, Desai M. Penicillin desensitization: Treatment of syphilis in pregnancy in penicillin-allergic patients. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2017;118(5):537-541.
The Scarborough Hospital. Desensitization Protocols; 2015. Adapted with permission.
Castells M. Rapid desensitization for hypersensitivity reactions to medications. Immunology and allergy clinics of North America. 2009;29(3):585-606.
Mirakian R, Leech SC, Krishna MT, et al. Management of allergy to penicillins and other beta-lactams. Clin Exp Allergy. 2015;45(2):300-327.
Yates AB. Management of patients with a history of allergy to beta-lactam antibiotics. Am J Med. 2008;121(7):572-576.
Liu A, Fanning L, Chong H, et al. Desensitization regimens for drug allergy: state of the art in the 21st century. Clin Exp Allergy. 2011;41(12):1679-1689.
Wendel GD, Jr., Stark BJ, Jamison RB, Molina RD, Sullivan TJ. Penicillin allergy and desensitization in serious infections during pregnancy. The New England journal of medicine. 1985;312(19):1229-1232.
Saskatoon Health Region. IV Antibiotic Desensitization for Type 1 Reaction Protocol: Cloxacillin.
Capital Health (NS). Antimicrobial Handbook - Beta-Lactam Desensitization Protocol. 2007.
Drug allergy: an updated practice parameter. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2010;105(4):259-273.
Blond-Hill E, Fryters S. Bugs and Drugs: An Antimicrobial/Infectious Disease. 2012:87-90.
Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and Management of Penicillin Allergy: A Review. JAMA. 2019;321(2):188-199.