Would love to hear from @EricMacyMD@TrubianoJason@blandman19
Would you consider this case as anaphylaxis with this limited info/time? Do you consider anaphylaxis a reason not to give cefazolin or to be cautious in penicillin allergy? #IDtwitter
I poured my heart and soul onto the page and this is the result:
doi.org/10.1093/cid/ciae089
Thank you to @shurtadobares and @PaulSaxMD for giving my voice a space. Thank you to @WendyStead5 and @MikeMeliaMD for the workshop on narrative writing at IDWeek 2023.
Perhaps we should change the name of the field in the EHR to WICAs, warnings, intolerances, cautions, and allergies to account for the reasons no to use or reuse a material or drug.
Allergy Lists: Ubiquitous, but Flawed doximity.com/newsfeed/1e28de… via @doximity
#ACAAI23 Baseline serum tryptase & #AlphaGal#IgE should be measured in recurring #anaphylaxis & in #biphasic -consider even if #foodAllergy suspected. Educate patients to ask ED for tryptase to be measured in 1st 90 minutes during severe reactions. Criteria for anaphylaxis vary
11 Kaiser Permanente medical centers in Southern California and @KPHawaii received an ‘A’ grade by the @LeapfrogGroup for achieving the highest national standards in patient safety in the Fall 2023 Leapfrog Hospital Safety Grades. Learn more: bit.ly/3soBmAl
Corticosteroids (in case you're going to think about it) has ZERO evidence to prevent biphasic reactions.
First generation antihistamines should NEVER be used in the context of anaphylaxis. Stay away! If you're even going to consider it, use 2nd and 3rd generation.
#CSACI23
(1/9) The USDAR (United States Drug Allergy Registry) group presents a consensus-developed, standardized, severity grading scale for immediate drug reactions in adults. This scale applies to both clinical care and research. sciencedirect.com/science/ar…
An important lesson here. Anaphylaxis occurred with systemic exposure to only about 0.5 mg of ampicillin. ID skin testing (0.02ml) using ampicillin 25 mg/ml.
Use 0.01 molar for beta-lactams.
Fatal ampicillin-sulbactam anaphylaxis in a 34-year-old male
jaci-global.org/article/S277…
The next lowest dose of a beta-lactam inducing fatal anaphylaxis that I could find was in a case report:
applications.emro.who.int/em…
Intradermal test dosing done with 0.2 ml of 300,000 IU/ml penicillin G or about 36 mg of penicillin.
👀💊9/28 is National Penicillin Allergy Day! I devoted much of my career to studying the negative impact of taking a reported penicillin allergy as truth and using alternative antibiotics. Some adverse consequences are preventable through penicillin allergy evaluation 1/3
Getting ready for National Penicillin Allergy Day de-labeling a patient who is pending cardiothoracic surgery and has a history of penicillin allergy. #NPAD@AAAAI_org@IDSAInfo@SHEA_Epi 1/5