Beyond Penicillin: Rapid Desensitization for Specific Flucloxacillin Hypersensitivity

Antimicrob Agents Chemother. 2018 Nov 26;62(12):e01371-18. doi: 10.1128/AAC.01371-18. Print 2018 Dec.

Abstract

Beta-lactam therapy for severe staphylococcal infections is associated with superior outcomes, compared to non-beta-lactam therapy. For patients with immediate hypersensitivity to beta-lactams, desensitization has been widely employed to allow beta-lactam therapy, but published protocols for antistaphylococcal beta-lactams such as flucloxacillin are lacking. Here, we report a case and describe the desensitization protocol successfully used for a patient with isolated flucloxacillin immediate hypersensitivity, for whom a penicillin desensitization protocol would likely have resulted in an adverse drug reaction.

Keywords: anaphylaxis; antibiotic allergy; desensitization; flucloxacillin; hypersensitivity; penicillin allergy.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects
  • Desensitization, Immunologic / methods*
  • Drug Administration Schedule
  • Drug Hypersensitivity / etiology
  • Drug Hypersensitivity / immunology
  • Drug Hypersensitivity / physiopathology
  • Drug Hypersensitivity / prevention & control*
  • Drug Monitoring
  • Endocarditis, Bacterial / drug therapy*
  • Endocarditis, Bacterial / immunology
  • Endocarditis, Bacterial / microbiology
  • Floxacillin / administration & dosage*
  • Floxacillin / adverse effects
  • Humans
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / immunology
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / growth & development
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Floxacillin