Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
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Ann. Allergy Asthma Immunol. · Jul 2016
Review Meta AnalysisA systematic review of epinephrine degradation with exposure to excessive heat or cold.
Epinephrine is a lifesaving drug in the treatment of anaphylaxis and cardiac resuscitation. Current US storage recommendations are for controlled room temperature (20°C-25°C), with excursions permitted from 15°C to 30°C. Maintaining epinephrine within this required range is challenging, particularly for patients carrying autoinjectors and during storage in emergency vehicles. ⋯ Temperature excursions in real-world conditions may be less detrimental than previously suggested. Freezing and limited heat excursions did not result in epinephrine degradation. Refrigeration of epinephrine appears to reduce degradation. However, the effect of extreme temperatures, particularly freezing, on autoinjectors is not sufficiently well established. More research in needed at clinically relevant high temperatures, with limited exposure to heat, and involving autoinjector devices.
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Ann. Allergy Asthma Immunol. · Jul 2016
Penicillin skin testing in hospitalized patients with β-lactam allergies: Effect on antibiotic selection and cost.
A history of a penicillin allergy generally leads to the use of broad-spectrum antibiotics that may increase complications and cost. ⋯ After the implementation of a PST protocol, we observed a decrease in non-BLA use in patients with previously documented β-lactam allergy. PST is a safe and cost-effective procedure to serve as a negative predictor test for penicillin hypersensitivity mediated by IgE.