Speaker: Dr. Ingo Sagoschen (Center for Cardiology)
Our aim is to establish and develop Infection Medicine practically with all its facets. This includes an adequate microbiological diagnostic, appropriate practiced infection prevention and a rational therapy with anti-infective substances.
The representatives of the following institutions of the University Medical Center are joining the “Interdisciplinary Infection Medicine Mainz”:
Further projects of the "Interdisciplinary Infection Medicine Mainz":
Structure / Organigram working group Infection Medicine of the University Medical Center Mainz (Pdf, 229,2 KB)
Penicillin allergy
Up to 10% of the population claim to have a penicillin allergy. In fact, 85-90% of all patients with anamnestic penicillin allergy tolerate penicillins because they are not or no longer allergic.
Consequences of a supposed penicillin allergy are avoidance of beta-lactam antibiotics such as penicillins and cephalosporins. Alternative anti-infectives are often less effective, have more side effects, induce more resistance and cause higher costs.
Patients, who claim to have a penicillin allergy, are for example twice as likely to receive vancomycin and three times as likely to receive fluoroquinolones. They have 23% more C. difficile infections, 14% more methicillin-resistant staphylococcus aureus (MRSA) infections and 30% more evidence of vancomycin-resistant enterococci (AER).
Therefore, a suspected penicillin allergy should always be clarified and not be taken over uncritically. In addition to in vitro tests, skin tests and oral provocation are available for testing.
A penicillin allergy does not has to last a lifetime: About 50% of patients with IgE-mediated penicillin allergy lose sensitivity 5 years after the last reaction (about 80% after 10 years!).
97-98% of patients with penicillin allergy confirmed by skin testing tolerate cephalosporins!
Patients, who urgently need to be treated with a beta-lactam antibiotic, a desensitization can be carried out at short notice.
Indication: patients with confirmed (positive skin test or in vitro test) or urgently suspected LgE-mediated immediate reaction to penicillin AND for whom there are no comparably effective alternatives.
Contraindication: Anamnesis of Stevens-Johnson syndrome, exfoliative dermatitis or erythroderma. A desensitization temporarily alters the immune response to the antibiotic in the sense of short-term tolerance, which enables a safe medication (if taken continuously!).
Sources:
In consultation with our colleagues at the virological institute, we have compiled information on the diagnosis of infections when COVID-19 is suspected. (Pdf, 721,4 KB)
Further information can be found on the websites of the Robert Koch-Institute (RKI) and the WHO.