Antibiotic allergy.

Blumenthal, Kimberly G; Peter, Jonny G; Trubiano, Jason A; Phillips, Elizabeth J

doi:10.1016/s0140-6736(18)32218-9

Cited by 614Drug-Induced Adverse ReactionsPharmacovigilance and Adverse Drug ReactionsFood Allergy and Anaphylaxis Research

Antibiotic allergy.

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Blumenthal, Kimberly G, Peter, Jonny G, Trubiano, Jason A, Phillips, Elizabeth J·2019·The Lancet

DOI 10.1016/s0140-6736(18)32218-9PMC PMC6563335

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Abstract

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-β-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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Prevalence of reported allergy to penicillin is approximately 10% among the U.S. population and higher among hospital inpatients and residents in health care-related facilities.
“Prevalence of reported allergy to penicillin is approximately 10% among the U.S. population and higher among hospital inpatients and residents in health care–related facilities (655–658).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [656]
The Epidemiology > β-Lactam antibiotics section reports that 5–15% of patients in developed countries carry a penicillin allergy label, which is consistent with an approximate 10% figure but does not establish it specifically for the U.S. population. Epidemiology > Special patient groups says labels are more common among inpatients and patients linked to ongoing ambulatory care than among single-visit outpatients; it does not address residents of health care–related facilities. Page numbers were not available in our copy. (LLM, conf=0.85)
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Authors: Blumenthal, K. G., Peter, J. G., Trubiano, J. A., & Phillips, E. J.
Affiliations: Harvard University (US)
University of Cape Town (ZA)
The University of Melbourne (AU)
Murdoch University (AU)
Corresponding author: Phillips, Elizabeth J
ORCID: Blumenthal, Kimberly G
Peter, Jonny G
Trubiano, Jason A
Phillips, Elizabeth J
Venue: The Lancet
Publisher: Elsevier BV
Published: 2019-01
Volume: 393
Issue: 10167
Pages: 183-198
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(18)32218-9
PMC: PMC6563335
OpenAlex: W4211095142
Cited by: 614
References: 134
Citations by year: 2026: 69 · 2025: 90 · 2024: 103 · 2023: 94 · 2022: 86 · 2021: 72 · 2020: 65 · 2019: 32
FWCI: 4.93
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Murdoch University Research Portal (submittedVersion)
Funders: National Institutes of Health, USA (K43 TW011178-01)
National Institute of Health, USA (1P50GM115305–01, 1P30AI110527–01A1, R21AI139021, and R34AI136815)
Topics: Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
Keywords: antibiotic allergy, drug hypersensitivity, penicillin allergy, anaphylaxis, severe cutaneous adverse reactions, antibiotic prophylaxis, antibiotic resistance, drug rechallenge, allergy testing, immune-mediated drug reactions
MeSH terms: Anaphylaxis, Anti-Bacterial Agents, beta-Lactamases, Cross Infection, Drug Hypersensitivity, Drug Resistance, Microbial, Female, Humans, Male, Penicillins, Risk Factors, Global Health

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