E-drug: desensitisation protocol for ceftazidime
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Does anyone have a protocol for desensitising a patient to
ceftazidime? Our patient previously experienced an anaphylactic
reaction with IV penicillin G; C&S results show that ceftazidime
is the only agent the bug is sensitive to. Thank you.
best wishes,
Shyam
Shyamala Narayanaswam
Assoc Clin Pharmacist
Drug Information Centre
Singapore General Hospital
Outram Road
Singapore 169608
REPUBLIC OF SINGAPORE
tel (65) 3214112
fax (65) 3231335
mailto: gpashy@sgh.com.sg
[The following information has been provided by Benafsha Khariwala,
Therapeutic Guidelines, Australia <bkhariwala@tg.com.au>.
- As the patient has a history of an immediate (anaphylactic) reaction to
penicillin, further exposure to penicillin and other beta-lactams
(carbapenems, cephalosporins) is contraindicated. Between 3 and 6
percent of patients hypersensitive to penicillin exhibit
cross-reactivity with cepalosporins.
Either oral (slow) or intravenous (rapid) penicillin desensitisation
could be considered as described in Therapeutic Guidelines:
Antibiotic Ed 11. p.277 and p.278 respectively (contact Benafsha for
details). BS]
[References:
Parker PJ, et al. Penicillin resensitization among hospitalized patients.
J Allergy Clin Immunol 1991; 88: 213-7.
Boris L, Tamir R, Rosenwasser LJ. Intravenous desensitization to
beta-lactam antibiotics. J Allergy Clin Immunol 1987; 80: 314-9.
Miles AM, Bain B. Penicillin anaphylaxis: a review of sensitization,
treatment and prevention. J Assoc Acad Min Phys 1992; 3: 50-6.
Lin RY. A perspective on penicillin allergy. Arch Intern Med 1992; 152:
930-7.
Gruchalla RS. Acute drug desensitization. Clin Exp Allergy 1998; 28: 63-4.]
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