Antibiotic Selection for Patients with Multiple Antibiotic Allergies

Assessment of Antibiotic Options

• The patient has allergies to multiple beta-lactam antibiotics, including penicillins, cephalosporins, and carbapenems, and guidelines recommend avoiding all beta-lactam antibiotics in patients with suspected severe delayed-type allergies to multiple beta-lactam classes 1, 2
• Despite susceptibility to certain antibiotics, they should be avoided due to the patient's documented allergies, according to guidelines from the Infectious Diseases Society of America 1, 2
• Gentamicin is the only antibiotic on the susceptibility list that belongs to a class (aminoglycosides) to which the patient has no documented allergy, with a strength of evidence supporting its use in patients with multiple antibiotic allergies 1

Alternative Approaches

• If gentamicin cannot be used, consider consultation with an infectious disease specialist and allergist for potential desensitization to one of the beta-lactam antibiotics, as recommended by the American Academy of Allergy, Asthma, and Immunology 1