Antibiotic desensitization as a potential tool in antimicrobial stewardship programs: retrospective data analysis and systematic literature review

ABSTRACT

Objectives

Antibiotic allergy labels (AAL) are related to worse therapeutic results. Strategies to improve the management of these patients, such as the implementation of antibiotic desensitization, are essential for Antimicrobial Stewardship Programs (ASP). The aim of our study is to evaluate the efficacy and safety of antibiotic desensitization procedures for the management of patients with AAL.

Methods

A retrospective study from 2015 to 2022 was performed to describe all antibiotic desensitization conducted in our institution, within the framework of ASP. A systematic literature review using electronic databases, such as PubMed, was also done to identify studies describing antibiotic desensitization between 2000 and 2022.

Results

Sixteen antibiotic desensitization protocols were carried out in our institution. In fourteen cases, the desensitization was successfully completed, and the antibiotic could be used to treat the infection. In the systematic review, twenty-two studies were included, with a total of 202 desensitization episodes . In 97% of them, the desensitization was completed successfully. No desensitization-related mortality was observed neither in our cohort nor in literature review.

Conclusions

Antibiotic desensitization strategies should be considered a safe and effective tool that can be included in ASP for patients with a high risk of or confirmed allergy to penicillin.

KEYWORDS:

• anti-bacterial agents
• antimicrobial stewardship programs
• desensitization
• immunologic
• hypersensitivity
• penicillins

Acknowledgments

We would like to thank Janet Dawson for English editing. This study is part of a PhD program in Medicine of the Universitat Autònoma de Barcelona (Spain). Silvia Gómez-Zorrilla has received a research grant from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) to support her research and the project “ PI21/00509 “funded by Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union. These data were previously presented, in part, in the 32nd European Congress of Clinical Microbiology and Infectious Diseases (2022), number 1673.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

A Rodríguez-Alarcón has substantially contributed to the conception and design of the review article and interpreting the relevant literature (1). J Barceló-Vidal has substantially contributed to the conception and design of the review article and interpreting the relevant literature (1). D Echeverría-Esnal has substantially contributed to the conception and design of the review article and interpreting the relevant literature (1). L Sorli has been involved in writing the review article or revised it for intellectual content (2). R Güerri-Fernández has been involved in writing the review article or revised it for intellectual content (2). S Martina Ramis Fernández has been involved in writing the review article or revised it for intellectual content (2). A Benitez-Cano has been involved in writing the review article or revised it for intellectual content (2). E Sendra has been involved in writing the review article or revised it for intellectual content (2). ILópez Montesinos has been involved in writing the review article or revised it for intellectual content (2). E Membrilla-Fernández has been involved in writing the review article or revised it for intellectual content (2). O Ferrandez has been involved in writing the review article or revised it for intellectual content (2). R Adalia has been involved in writing the review article or revised it for intellectual content (2). J Pablo Horcajada has been involved in writing the review article or revised it for intellectual content (2). F Escolano has been involved in writing the review article or revised it for intellectual content (2). S Gómez-Zorrilla has substantially contributed to the conception and design of the review article and interpreting the relevant literature (1). S Grau has substantially contributed to the conception and design of the review article and interpreting the relevant literature (1).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14787210.2022.2122443

Additional information

Funding

This paper was not funded.