Brief communication: tolerability of meropenem in patients with IgE-mediated hypersensitivity to penicillins.

Abstract

BACKGROUND:

Although clinicians avoid giving meropenem to patients with penicillin allergy because of potential cross-reactivity, the rate of cross-reactivity between penicillins and meropenem has not been prospectively determined.

OBJECTIVE:

To assess the tolerability of meropenem in patients with documented penicillin allergy.

DESIGN:

Prospective skin testing and antibiotic challenge.

SETTING:

Allergy units of 2 Italian medical centers.

PATIENTS:

104 consecutive participants with immediate hypersensitivity reactions to penicillins and positive skin test results to at least 1 penicillin reagent.

MEASUREMENTS:

Skin tests to meropenem and, if results were negative, challenges with escalating doses of meropenem.

RESULTS:

One participant (0.9% [95% CI, 0.02% to 5.2%]) had a positive intradermal test result to meropenem. The remaining 103 participants with negative skin test results to meropenem tolerated escalating dose challenges.

LIMITATION:

Challenges were not followed by therapeutic courses.

CONCLUSIONS:

These data indicate a low rate of cross-reactivity between penicillins and meropenem. Therefore, the practice of avoiding meropenem therapy in penicillin-allergic patients should be reconsidered. In patients who especially require meropenem treatment, the authors recommend pretreatment skin tests because negative results indicate tolerability.

• Authors: Antonino Romano, Marinella Viola, Rosa-Maria Guéant-Rodriguez, Francesco Gaeta, Rocco Valluzzi, Jean-Louis Guéant
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 146 Issue 4 Pg. 266-9 (Feb 20 2007) ISSN: 1539-3704 [Electronic] United States
• PMID: 17310050 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin II Type 1 Receptor Blockers
• Anti-Bacterial Agents
• Anticoagulants
• Penicillins
• Thienamycins
• Meropenem

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Angiotensin II Type 1 Receptor Blockers (therapeutic use)
• Anti-Bacterial Agents (administration & dosage, adverse effects, immunology)
• Anticoagulants (therapeutic use)
• Cross Reactions
• Female
• Humans
• Hypersensitivity, Immediate (chemically induced)
• Male
• Meropenem
• Middle Aged
• Penicillins (adverse effects)
• Prospective Studies
• Skin Tests
• Thienamycins (administration & dosage, adverse effects, immunology)