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Welke patiënten met een gerapporteerde ß-lactam allergie kunnen een carbapenem krijgen?

Recommendation

Strength

Quality of evidence

24. We recommend that patients with suspected or proven immediate type penicillin allergy, irrespective of severity or time since the index reaction, can receive any monobactam or carbapenem, without prior allergy testing.

Strong

Low

25. We recommend that patients with a suspected or proven non-severe, delayed type penicillin allergy, irrespective of severity or time since the index reaction, can receive any monobactam or carbapenem, without prior allergy testing.

Strong

Low

26. We recommend that in patients with suspected severe delayed type allergy (zie Indeling type allergie) to penicillins, all monobactams and carbapenems should be avoided, irrespective of time since the index reaction. In the absence of acceptable alternative antimicrobial treatment, the use of monobactams or carbapenems should be discussed in a multidisciplinary team*.

Strong

GPS

*An expert team that consists of an infectious diseases specialist and/ or microbiologist, pharmacist and if available an allergist. The risk of side effects and benefits of use of proper antibiotic should be balanced against each other followed by shared decision making with the patient. If the multidisciplinary team concludes the monobactam or carbapenem may be used in case of a suspected or proven severe delayed type penicillin allergy, the monobactam or carbapenem should be administered under prolonged medical supervision.

 

Bron:  SWAB guideline for the approach to suspected Antibiotic Allergy, 2022.  Richtlijn downloaden: 192 (swab.nl)