oa Current Allergy & Clinical Immunology - Antibiotic allergy in the intensive care unit : review article

Volume 20 Number 3
  • ISSN : 1609-3607



Drug allergy in an intensive care unit (ICU) may be more common than realised. Antibiotics are the main drug involved and few patients have a previous history of drug reaction. Of all drug and antibiotic allergic reactions, allergy to beta-lactams is the most common reaction. Beta-lactam allergy is common enough for most clinicians to have an approach to this condition but since other drug allergies are less common, less often diagnosed, and often lack validated diagnostic tests, they are usually managed poorly. Based on the risk factors, the most important statement regarding clinical presentation of drug allergy is that a high index of suspicion is the most useful clue to suspected allergy. Testing strategies need to confirm allergy and skin-prick testing is useful in many circumstances. Treatment of a proven antibiotic allergy may include avoidance, but because the ICU patient frequently harbours an organism that has multiple antibiotic resistance patterns and demands use of a drug despite suspected allergy, methods of desensitisation should be known.

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