To start, please evaluate if the patient experienced symptoms suggestive of an immediate or delayed type reaction.
Overview clinical criteria for anaphylaxis:
Anaphylaxis defined as rapid (<6 h) simultaneous involvement of ≥2 organ systems following exposure to culprit drug:
Skin and/or mucosal tissue: rash, pruritus, erythema, hives/urticaria, swelling of the face, lips, tongue, or uvula.
Respiratory symptoms: dyspnea, wheeze, bronchospasm,, stridor, hypoxemia, persistent cough and/or throat clearing.
Severe gastrointestinal symptoms: severe crampy abdominal pain with diarrhea, repetitive vomiting.
Cardiovascular symptoms: hypotension: systolic blood pressure <90 mm Hg or a decrease of >30% from baseline.
Overview severe delayed type reactions (SCAR):
Overview of severe adverse reactions, including: AGEP: Acute Generalized Exanthematous Pustulosis; DRESS: Drug Reaction with Eosonophilia and Systemic Symptoms; SJS: Stevens-Johnson Syndrome; TEN: Toxic Epidermal Necrolysis.
Reference:
Li PH, Thong BY, Pawankar R, Jeewandara C, Lobo RCM, Kang HR, et al. APAAACI clinical pathway on direct provocation testing for penicillin allergy delabeling. Asia Pac Allergy. 2023;13(4):142-147. doi: 10.5415/apallergy.0000000000000122.
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