#IDsky #pcnallergy #Medsky

PCN Allergies, day 7: I’ll end the week of #PCNallergy links with a shout-out to all the awesome work done by pharmacists in this space this past year! See thread below for 5 RPh-led studies from 2019 & tune in tonight for the full presentation 1/8

PCN Allergies, day 7: I’ll end the week of #PCNallergy links with a shout-out to all the awesome work done by pharmacists in this space this past year! See thread below for 5 RPh-led studies from 2019 & tune in tonight for the full presentation 1/8

PCN Allergies, day 6: skin testing for #PCNallergy isn't necessary for most patients. This RCT from @JACIInPractice in June showed that direct oral amoxicillin challenges were safe and effective to rule out allergy in low-risk patients @MAPharmacists

PCN Allergies, day 6: skin testing for #PCNallergy isn't necessary for most patients. This RCT from @JACIInPractice in June showed that direct oral amoxicillin challenges were safe and effective to rule out allergy in low-risk patients @MAPharmacists

PCN Allergies, day 5: The Penicillin Skin Test Kit, in addition to major and minor allergenic determinants, also contains an amoxicillin skin test. In this prospective study, it had a negative predictive value of 98% #PCNallergy @MAPharmacists 1/3

PCN Allergies, day 5: The Penicillin Skin Test Kit, in addition to major and minor allergenic determinants, also contains an amoxicillin skin test. In this prospective study, it had a negative predictive value of 98% #PCNallergy @MAPharmacists 1/3

PCN Allergies, day 4: A meta-analysis looked at cross-reactivity potential in #PCNallergy patients. Cross-reactivity varied: 16.5% chance for cephalosporins with similar R1 side chains, 2.1% for cephs with different side chains, and 0.9% for carbapenems

PCN Allergies, day 4: A meta-analysis looked at cross-reactivity potential in #PCNallergy patients. Cross-reactivity varied: 16.5% chance for cephalosporins with similar R1 side chains, 2.1% for cephs with different side chains, and 0.9% for carbapenems

PCN Allergy Study, day 3: this retrospective cohort () showed an increase in risk of surgical site infection in #PCNallergy patients (OR 1.61), very similar to previous findings by @KimberlyBlumen1 () @MAPharmacists

PCN Allergy Study, day 3: this retrospective cohort () showed an increase in risk of surgical site infection in #PCNallergy patients (OR 1.61), very similar to previous findings by @KimberlyBlumen1 () @MAPharmacists

PCN Allergy Study, day 2: an enormous population-based data set was published by @EricMacyMD and @aboutKP. ~6 million PCN courses, only 25 cases of anaphylaxis (~1 in 240,000 exposures), which was only 0.067% of the new #PCNallergy reports @MAPharmacists

PCN Allergy Study, day 2: an enormous population-based data set was published by @EricMacyMD and @aboutKP. ~6 million PCN courses, only 25 cases of anaphylaxis (~1 in 240,000 exposures), which was only 0.067% of the new #PCNallergy reports @MAPharmacists

PCN Allergy Study, day 1: some stellar #PCNallergy reviews have come out over the past year. @KimberlyBlumen1 in @TheLancet. @ericashenoy in @JAMA_current. And now, Maria Castells in @NEJM @MAPharmacists

PCN Allergy Study, day 1: some stellar #PCNallergy reviews have come out over the past year. @KimberlyBlumen1 in @TheLancet. @ericashenoy in @JAMA_current. And now, Maria Castells in @NEJM @MAPharmacists

Part 3 on assessing beta-lactam allergies is out now on ! My final post in the series covers how to best document an allergy, desensitization, penicillin skin testing, and more #foamid #IDTwitter #FOAMed #PCNallergy @foamid

Part 3 on assessing beta-lactam allergies is out now on ! My final post in the series covers how to best document an allergy, desensitization, penicillin skin testing, and more #foamid #IDTwitter #FOAMed #PCNallergy @foamid

Side-chain similarities are key to interpreting the chances of cross-reactivity among different cephalosporins. The table below is adapted (and updated) from this excellent 2008 review article: #PCNallergy @Kerry_LaPlante

Side-chain similarities are key to interpreting the chances of cross-reactivity among different cephalosporins. The table below is adapted (and updated) from this excellent 2008 review article: #PCNallergy @Kerry_LaPlante

Did you miss the live CE on beta-lactam allergies a few months ago? Don't fret, it's now available online! Free for @MAPharmacists members #PCNallergy

Did you miss the live CE on beta-lactam allergies a few months ago? Don't fret, it's now available online! Free for @MAPharmacists members #PCNallergy

The supplementary material with all of the allergy toolkits is 💯 #PCNallergy @KimberlyBlumen1 @EricMacyMD

The supplementary material with all of the allergy toolkits is 💯 #PCNallergy @KimberlyBlumen1 @EricMacyMD

PCN Allergy Fact, day 7: There’s too much to cover via Twitter, but I’ll leave you with one last clinical pearl. De-label PCN allergies --> re-label PCN allergies. Don’t remove the allergy altogether as they’ll just be re-entered on the next admission! @MAPharmacists #PCNallergy

PCN Allergy Fact, day 7: There’s too much to cover via Twitter, but I’ll leave you with one last clinical pearl. De-label PCN allergies --> re-label PCN allergies. Don’t remove the allergy altogether as they’ll just be re-entered on the next admission! @MAPharmacists #PCNallergy

PCN Allergy Fact, day 6: Despite benefits of PCN skin testing, the practice has not been widely adopted throughout the US. Who will take ownership? In a 2015 survey, 57% of ID MDs stated that they don’t have access to skin testing @TrubianoJason @MAPharmacists #PCNallergy (1/4)

PCN Allergy Fact, day 6: Despite benefits of PCN skin testing, the practice has not been widely adopted throughout the US. Who will take ownership? In a 2015 survey, 57% of ID MDs stated that they don’t have access to skin testing @TrubianoJason @MAPharmacists #PCNallergy (1/4)

Let’s start day 6 of #PCNallergy with a poll! Does your institution provide penicillin skin testing?

Let’s start day 6 of #PCNallergy with a poll! Does your institution provide penicillin skin testing?

PCN Allergy Fact, day 5: PCN skin testing is an excellent way to rule out Type 1 PCN allergy, with ~99% NPV. Even with cost of the test (~$140) & time it takes to administer (~45-60 mins), PCN skin testing is cost effective @joeymattingly @bruce_m_jones @MAPharmacists #PCNallergy