piperacillin--tazobactam-drug-combination and Urticaria

Piperacillin/tazobactam is a broad-spectrum antibiotic that is widely used and commonly administered via the intravenous (i.v.) piggyback route over 0.5 to 4.0 hours. Recommendations for i.v. push (IVP) administration of piperacillin/tazobactam are lacking due to the high osmolality of the solution. The primary objective of this study was to retrospectively assess the safety and tolerability of piperacillin/tazobactam administered peripherally by IVP. Methods. A retrospective chart review was conducted to evaluate adverse drug reactions after administration of a single dose of IVP piperacillin/tazobactam through a peripheral line in an emergency department from August 2016 through November 2017.. A total of 1,813 patients received 1 dose of IVP piperacillin/tazobactam during the study timeframe. Three hundred patients were randomly selected for assessment of safety and tolerability. Two hundred ninety-nine patients (99.7%) tolerated IVP piperacillin/tazobactam. One patient had an allergic reaction that included itching and hives. No infusion-related reactions were documented.. IVP administration of piperacillin/tazobactam through a peripheral site is safe and tolerable for adult patients.

Topics: Academic Medical Centers; Administration, Intravenous; Adult; Anti-Bacterial Agents; Emergency Service, Hospital; Female; Humans; Male; Middle Aged; Piperacillin, Tazobactam Drug Combination; Retrospective Studies; Urticaria

Skin prick testing (SPT) has been regarded as a safe procedure with few systemic reactions.. To evaluate the rate of systemic reactions and their associations after SPT in the largest population to date.. In this study reactions were recorded prospectively in a specialist UK allergy clinic for 6 years (2007-2013). An estimated 31,000 patients underwent SPT.. Twenty-four patients (age range 7 months to 56 years, mean 23.5 years, 17 female patients, 12 with asthma) had systemic reactions. The rate of systemic reactions to SPT was 0.077%. The likely allergens causing the reaction were foods (18; peanut, 7; walnut, 1; Brazil nut, 2; pistachio, 1; lupin, 1; cow's milk, 2; shrimp, 1; spinach, 1; legume, 1; soy, 1), aeroallergens (4; rabbit, 1; rat, 1; ragwort, 1; grass pollen, 1), wasp venom (1), and Tazocin (1). The causative SPT wheal was larger than 8 mm in 75%. The reaction to Tazocin was severe, with anaphylaxis occurring minutes after SPT. Reactions were treated immediately in the clinic and did not require further medical care.. In this largest single-center study, the rate of systemic reactions after SPT was 77 per 100,000 patients. It is the first study to identify foods as a common and important cause (75%), with nuts posing the highest risk. This study reports the first systemic reaction to venom SPT and the first anaphylactic reaction after drug SPT. There was an association with a history of severe reactions and large skin test reaction. There are risks, albeit small, when undertaking SPT.

Topics: Adolescent; Adult; Allergens; Anaphylaxis; Child; Child, Preschool; Erythema; Female; Food Hypersensitivity; Humans; Infant; Male; Middle Aged; Nut Hypersensitivity; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Prospective Studies; Retrospective Studies; Skin Tests; Urticaria; Young Adult