期刊
LANCET
卷 393, 期 10167, 页码 183-198出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(18)32218-9
关键词
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资金
- National Institutes of Health, USA
- American Academy of Allergy, Asthma and Immunology Foundation, USA
- National Institutes of Health, USA [K43 TW011178-01, 1P50GM115305-01, 1P30AI110527-01A1, R21AI139021, R34AI136815]
- National Health and Medical Research Council (NHMRC) of Australia Early Careers Fellowship
- National Centre for Infections in Cancer (NCIC, Australia)
- NHMRC of Australia
- Australian Centre for HIV and Hepatitis Virology Research
Antibiotics are the commonest cause of life-threatening immune-mediated drug reactions that are considered off-target, including anaphylaxis, and organ-specific and severe cutaneous adverse reactions. However, many antibiotic reactions documented as allergies were unknown or not remembered by the patient, cutaneous reactions unrelated to drug hypersensitivity, drug-infection interactions, or drug intolerances. Although such reactions pose negligible risk to patients, they currently represent a global threat to public health. Antibiotic allergy labels result in displacement of first-line therapies for antibiotic prophylaxis and treatment. A penicillin allergy label, in particular, is associated with increased use of broad-spectrum and non-beta-lactam antibiotics, which results in increased adverse events and antibiotic resistance. Most patients labelled as allergic to penicillins are not allergic when appropriately stratified for risk, tested, and re-challenged. Given the public health importance of penicillin allergy, this Review provides a global update on antibiotic allergy epidemiology, classification, mechanisms, and management.
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