While data specific to cross-reactivity between meropenem and ampicillin is lacking, existing guidelines suggest that carbapenems can be administered to patients with a history of penicillin or cephalosporin allergy without the need for additional testing, even in cases of prior anaphylactic reactions. The overall incidence of carbapenem allergy is low, with clinical cross-reactivity rates between carbapenems and penicillins generally reported to be less than 1%. This suggests that meropenem ...
The American Academy of Allergy, Asthma, and Immunology (AAAAI) and the American College of Allergy, Asthma, and Immunology (ACAAI) developed the 2022 practice parameter update on drug allergies, which addresses the topic of beta-lactam cross-reactivity. It was highlighted that guidance on administering carbapenems to patients with penicillin allergy has changed since the previous drug allergy practice parameter update. Though not specific to ampicillin, the panel suggests that in patients with a history of penicillin or cephalosporin allergy, carbapenems may be administered without testing or additional precautions, even in cases where the previous reaction was anaphylactic (conditional recommendation, moderate certainty of evidence). [1]
The reported incidence of carbapenem allergy ranges from 0.3% to 3.7%. Clinical cross-reactivity between carbapenems and other beta-lactams is low, with multiple review articles reporting a cross-sensitivity risk of less than 1% between penicil...
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A search of the published medical literature revealed
6 studies investigating the researchable question:
In patients with true allergy to penicillin, what is the chance of cross-reactivity with meropenem?
Level of evidence
C - Multiple studies with limitations or conflicting results
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[1] Khan DA, Banerji A, Blumenthal KG, et al. Drug allergy: A 2022 practice parameter update. J Allergy Clin Immunol. 2022;150(6):1333-1393. doi:10.1016/j.jaci.2022.08.028
[2] Kula B, Djordjevic G, Robinson JL. A systematic review: can one prescribe carbapenems to patients with IgE-mediated allergy to penicillins or cephalosporins? [published correction appears in Clin Infect Dis. 2015 Jan 1;60(1):175] [published correction appears in Clin Infect Dis. 2015 Jan 1;60(1):175. doi: 10.1093/cid/ciu858]. Clin Infect Dis. 2014;59(8):1113-1122. doi:10.1093/cid/ciu587
[3] Picard M, Robitaille G, K...