Management of a surgical patient with a label of penicillin allergy: narrative review and consensus recommendations

被引：36

作者：

Savic, L. C. ^{[1
]}

Khan, D. A. ^{[2
]}

Kopac, P. ^{[3
]}

Clarke, R. C. ^{[4
,5
]}

Cooke, P. J. ^{[6
]}

Dewachter, P. ^{[7
,8
]}

Ebo, D. G. ^{[9
]}

Garcez, T. ^{[10
]}

Garvey, L. H. ^{[11
,12
]}

Guttormsen, A. B. ^{[13
,14
]}

Hopkins, P. M. ^{[1
,15
]}

Hepner, D. L. ^{[16
]}

Kolawole, H. ^{[17
,18
]}

Kroigaard, M. ^{[11
]}

Laguna, J. J. ^{[19
]}

Marshall, S. D. ^{[17
,18
]}

Mertes, P. M. ^{[20
]}

Platt, P. R. ^{[4
,5
]}

Rose, M. A. ^{[21
,22
]}

Sabato, V. ^{[9
]}

Sadleir, P. H. M. ^{[4
,5
,23
]}

Savic, S. ^{[24
]}

Takazawa, T. ^{[25
]}

Voltoli, S. ^{[26
]}

Volcheck, G. W. ^{[27
]}

机构：

[1] Leeds Teaching Hosp NHS Trust, Anaesthet Dept, Leeds, W Yorkshire, England

[2] Univ Texas Southwestern Med Ctr Dallas, Dept Internal Med, Div Allergy & Immunol, Dallas, TX USA

[3] Univ Clin Resp & Allerg Dis Golnik, Golnik, Slovenia

[4] Sir Charles Gairdner Hosp, Dept Anaesthesia, Nedlands, WA, Australia

[5] Anaesthet Allergy Referral Ctr Western Australia, Nedlands, WA, Australia

[6] Auckland City Hosp, Dept Anaesthesia & Perioperat Med, Auckland, New Zealand

[7] Grp Hosp Paris Seine St Denis, AP HP, Serv Anesthesie Reanimat, Paris, France

[8] Univ Paris 13, Sorbonne Paris Cite, Paris, France

[9] Univ Antwerp, Antwerp Univ Hosp, Dept Immunol Allergol & Rheumatol, Antwerp, Belgium

[10] Manchester Univ NHS Fdn Trust, Dept Immunol, Manchester, Lancs, England

[11] Copenhagen Univ Hosp, Dept Dermatol & Allergy, Danish Anaesthesia Allergy Ctr, Allergy Clin, Gentofte, Denmark

[12] Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark

[13] Haukeland Hosp, Dept Anaesthesia & Intens Care, Bergen, Norway

[14] Univ Bergen, Dept Clin Med, Bergen, Norway

[15] Univ Leeds, Leeds Inst Med Res St Jamess, Leeds, W Yorkshire, England

[16] Brigham & Womens Hosp, Dept Anesthesiol, 75 Francis St, Boston, MA 02115 USA

[17] Monash Univ, Dept Anaesthesia & Perioperat Med, Melbourne, Vic, Australia

[18] Peninsula Hlth, Dept Anaesthesia, Melbourne, Vic, Australia

[19] Alfonso X El Sabio Univ, Hosp Cent Cruz Roja, Allergoanaesthesia Unit, Allergy Unit,Fac Med,ARADyAL, Madrid, Spain

[20] Hop Univ Strasbourg, Nouvel Hop Civil, Dept Anesthesia & Intens Care, Strasbourg, France

[21] Royal North Shore Hosp, Dept Anaesthesia, Sydney, NSW, Australia

[22] Univ Sydney, Sydney, NSW, Australia

[23] Univ Western Australia, Dept Pharmacol, Crawley, WA, Australia

[24] Leeds Teaching Hosp NHS Trust, Dept Clin Immunol & Allergy, Leeds, W Yorkshire, England

[25] Gunma Univ Hosp, Intens Care Unit, Maebashi, Gunma, Japan

[26] Policlin Hosp San Martino, Allergy Unit, Genoa, Italy

[27] Mayo Clin, Coll Med, Div Allerg Dis, Rochester, MN USA

来源：

BRITISH JOURNAL OF ANAESTHESIA | 2019年 / 123卷 / 01期

基金：

英国医学研究理事会;

关键词：

allergy; drug provocation testing; penicillin; prophylaxis; surgery; surgical site infection; BETA-LACTAM ALLERGY; POSITIVE SKIN-TEST; DRUG ALLERGY; HOSPITALIZED-PATIENTS; MINOR DETERMINANTS; SITE INFECTION; ANTIMICROBIAL PROPHYLAXIS; ADVERSE-REACTIONS; CROSS-REACTIVITY; HYPERSENSITIVITY;

D O I：

10.1016/j.bja.2019.01.026

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Unsubstantiated penicillin-allergy labels are common in surgical patients, and can lead to significant harm through avoidance of best first-line prophylaxis of surgical site infections and increased infection with resistant bacterial strains. Up to 98% of penicillin-allergy labels are incorrect when tested. Because of the scarcity of trained allergists in all healthcare systems, only a minority of surgical patients have the opportunity to undergo testing and de-labelling before surgery. Testing pathways can be modified and shortened in selected patients. A variety of healthcare professionals can, with appropriate training and in collaboration with allergists, provide testing for selected patients. We review how patients might be assessed, the appropriate testing strategies that can be used, and the minimum standards of safe testing.

引用

页码：E82 / E94

页数：13

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