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PHARMACY Pearls

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ALLERGIES:

  • Only ~5-10% of people who think they are penicillin allergic actually are.
  • Penicillin allergy tends to wane over time, so the longer since the reaction, the less the risk of another one.
  • Using alternative ABX increases cost and length of hospital stay.
  • The risk of cross-reactivity in penicillin allergic patients with cephalosporins and carbapenems is ~2% and ~1% respectively
  • There is not cross reactivity between penicillin and monobactams like aztreonam
  • Most experts feel that cephalosporins may be given to those with a prior penicillin reaction that only involved the skin
  • Anyone who is allergy prone has a higher risk of allergy to any new ABX.  That rate might already be ~1-2%
  • LINKS: https://www.pharmacytimes.com/publications/health-system-edition/2017/may2017/penicillin-allergies-and-crossreactivity-with-other-betalactams

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ANIMAL BITES:

PREGNANCY:

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UTI’s:

MACROBID

  • Macrobid in elderly patients with reduced creatinine clearance may be ill advised because it is not adequately excreted into the urine.

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FOR EVERYTHING DRUG RELATED IN EMERGENCY MEDICINE CHECK OUT THE A to Z POCKET EMERGENCY PHARMACOPOEIA & ANTIBIOTIC GUIDE

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