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The following is a summary of “Discrepancies in Beta-Lactam Antibiotics Cross-Reactivity: Implications for Clinical Practice,” published in the February 2025 issue of European Journal of Allergy and Clinical Immunology by Hutten et al.
Avoiding all beta-lactam antibiotic (BA) shifts first-line therapies, impacting outcomes and resistance. Variability in cross-reactivity data causes inconsistent advice.
Researchers conducted a retrospective study on BA cross-reactivity, finding varying BA sets and conflicting recommendations
They identified discrepancies in BA cross-allergy and research gaps by evaluating tables and errata from 4 studies: Romano et al., Trubiano et al., Zagursky et al., and SWAB-guideline by Wijnakker et al.
The results showed that 51 antibiotics led to 2,550 potential recommendations. Internal discrepancies were found in 2 tables. Due to incomplete data, 356 situations lacked specific alternatives, and 1,104 had advice from only one author. Among 1,090 evaluated cases, 696 showed harmony (482 safe, 214 unsafe), while 394 had discrepancies. Different advice (safe vs unsafe) occurred in 272 cases (69%).
Investigators identified disharmony in 36% of cases, leading to different advice in 69%. This highlighted the need to synchronize cross-reactivity tables and address research gaps.
Source: onlinelibrary.wiley.com/doi/10.1111/all.16485
