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首页> 外文期刊>Allergy >Tolerability of meropenem in children with IgE-mediated hypersensitivity to penicillins.
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Tolerability of meropenem in children with IgE-mediated hypersensitivity to penicillins.

机译：美洛培南对IgE介导的对青霉素过敏的儿童的耐受性。

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BACKGROUND: Administration of meropenem to penicillin-allergic patients who might benefit from this treatment is usually avoided because of a 47.4% rate of cross-reactivity to imipenem, the prototype of the carbapenem class of beta-lactam antibiotics, demonstrated in a single study on the basis of positive responses to skin tests with imipenem reagents. However, recent studies of ours have demonstrated a very low rate of cross-reactivity between penicillins and both meropenem and imipenem in adults. OBJECTIVE: To assess cross-reactivity and tolerability of meropenem in children with documented penicillin allergy. METHODS: One hundred and eight consecutive children who had suffered a total of 129 immediate reactions (120 urticarial and/or angioedematous manifestations and 9 anaphylactic shocks) to penicillins and had positive results to skin tests for at least one of the penicillin reagents tested underwent skin tests with meropenem and negative subjects were challenged with it. RESULTS: One subject (0.9%) displayed a positive intradermal test to meropenem. The remaining 107 subjects with negative skin tests to meropenem tolerated challenges. Challenges were not followed by full therapeutic courses. CONCLUSIONS: Our results demonstrate a low rate of cross-reactivity between penicillins and meropenem. Therefore, the practice of avoiding meropenem in children with immunoglobulin E-mediated hypersensitivity could be abandoned; in those who especially require meropenem treatment, prophylactic skin tests are advisable, because negative results indicate tolerability.
机译：背景：在一项单项研究中证明，由于与亚胺培南的交叉反应率达到47.4％，亚胺培南与青霉素过敏的患者可能受益于美洛培南，而亚胺培南与碳青霉烯类β-内酰胺类抗生素的原型具有47.4％的交叉反应率。亚胺培南试剂对皮肤测试呈阳性反应的基础。但是，我们的最新研究表明，成人青霉素与美洛培南和亚胺培南之间的交叉反应率非常低。目的：评估美洛培南在青霉素过敏儿童中的交叉反应性和耐受性。方法：108名连续儿童对青霉素发生了总共129次即刻反应（120例荨麻疹和/或血管性水肿表现和9例过敏性休克），并且至少对一种经测试的青霉素试剂进行了皮肤试验，皮肤试验呈阳性结果美罗培南和阴性受试者的测试都受到了挑战。结果：一名受试者（0.9％）对美罗培南的皮内测试阳性。其余107名皮肤测试阴性的受试者对美洛培南耐受的挑战。完整的治疗课程并未解决挑战。结论：我们的结果表明青霉素与美罗培南之间的交叉反应率较低。因此，可以避免在免疫球蛋白E介导的超敏反应的儿童中避免使用美罗培南的做法;在特别需要美罗培南治疗的患者中，建议进行皮肤预防性检查，因为阴性结果表明可以耐受。

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