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Allergologie select, Volume 9 (2025) - 1st issue (28 - 39)

Recommendations on how to proceed in case of suspected allergy to penicillin/β-lactam antibiotics. Position paper of the German Society for Allergology and Clinical Immunology (DGAKI) in cooperation with the German Society for Pediatric Allergology (
Knut Brockow1, Wolfgang Pfützner2, Bettina Wedi3, Gerda Wurpts4, Axel Trautmann5, Burkhard Kreft6, Timo Buhl7, Mathias Sulk8, Andreas Recke9, Kathrin Scherer10, Stefan Wöhrl11, Irena Neustädter12, Regina Treudler13, Christiane Querbach14, Margitta Worm15
1 Department of Dermatology and Allergology Biederstein, Faculty of Medicine and Health, Technical University of Munich, Munich, 2 Department of Dermatology and Allergology, University Hospital Giessen and Marburg, Marburg, 3 Hanover Medical School, Department of Dermatology, Allergology and Venereology, Hanover, 4 Department of Dermatology and Allergology, Germany, Aachen Comprehensive Allergy Center (ACAC), University Hospital of RWTH Aachen University, Aachen, 5 Department of Dermatology and Allergology, Allergy Center Mainfranken, University Hospital Würzburg, Würzburg, 6 Department of Dermatology and Venereology, University Hospital Halle, Halle (Saale), 7 Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, 8 Department of Dermatology, Münster University Hospital, Münster, 9 Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Holstein Campus Lübeck, Lübeck, Germany, 1  0 Department of Dermatology, Cantonal Hospital Aarau, Aarau, and Department of Dermatology and Allergology, University Hospital Basel, Switzerland, 1  1 Floridsdorf Allergy Center (FAZ), Vienna, Austria, 1  2 Pediatric Clinic, Diakoneo Klinik Hallerwiese-Cnopfsche Kinderklinik, Nuremberg, 1  3 Institute for Allergy Research, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, 1  4 Hospital Pharmacy, Klinikum rechts der Isar, Technical University of Munich, Munich, and 1  5 Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany

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DOI 10.5414/ALX02531E

Abstract

β-lactam antibiotics (BLAs) are still the antibiotics of first choice for the treatment of many bacterial infections. Treatment with a BLA is often hindered by a suspected allergy, up to 10% of the population report an allergy to penicillin. After Position Paper allergological evaluation of the suspected allergic reaction to a BLA, most patients show a low probability of a BLA allergy; only in a minority of cases an allergic reaction to the repeated administration of a BLA appear likely in view of the previous history. In > 90% of cases, the suspected BLA allergy can be ruled out by allergy diagnostics. We recommend a risk-stratified approach in the context of an urgent need for BLA, which should enable most patients to receive a BLA therapy. After acute therapy, allergy diagnostics have to be done to clearly prove or reliably rule out a BLA allergy.

Author Details

Authors

Departments

  • 1 Department of Dermatology and Allergology Biederstein, Faculty of Medicine and Health, Technical University of Munich, Munich,
  • 2 Department of Dermatology and Allergology, University Hospital Giessen and Marburg, Marburg,
  • 3 Hanover Medical School, Department of Dermatology, Allergology and Venereology, Hanover,
  • 4 Department of Dermatology and Allergology, Germany, Aachen Comprehensive Allergy Center (ACAC), University Hospital of RWTH Aachen University, Aachen,
  • 5 Department of Dermatology and Allergology, Allergy Center Mainfranken, University Hospital Würzburg, Würzburg,
  • 6 Department of Dermatology and Venereology, University Hospital Halle, Halle (Saale),
  • 7 Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen,
  • 8 Department of Dermatology, Münster University Hospital, Münster,
  • 9 Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Holstein Campus Lübeck, Lübeck, Germany,
  • 1 
  • 0 Department of Dermatology, Cantonal Hospital Aarau, Aarau, and Department of Dermatology and Allergology, University Hospital Basel, Switzerland,
  • 1 
  • 1 Floridsdorf Allergy Center (FAZ), Vienna, Austria,
  • 1 
  • 2 Pediatric Clinic, Diakoneo Klinik Hallerwiese-Cnopfsche Kinderklinik, Nuremberg,
  • 1 
  • 3 Institute for Allergy Research, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin,
  • 1 
  • 4 Hospital Pharmacy, Klinikum rechts der Isar, Technical University of Munich, Munich, and
  • 1 
  • 5 Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany

Address

Prof. Dr. med. Knut Brockow, Department of Dermatology and Allergology Biederstein, Faculty of Medicine and Health, Technical University of Munich, Biedersteiner Strasse 29, 80802 Munich, Germany
Email: [email protected]

Citation

Knut Brockow, Wolfgang Pfützner, Bettina Wedi, Gerda Wurpts, Axel Trautmann, Burkhard Kreft, Timo Buhl, Mathias Sulk, Andreas Recke, Kathrin Scherer, Stefan Wöhrl, Irena Neustädter, Regina Treudler, Christiane Querbach, and Margitta Worm.Recommendations on how to proceed in case of suspected allergy to penicillin/β-lactam antibiotics. Position paper of the German Society for Allergology and Clinical Immunology (DGAKI) in cooperation with the German Society for Pediatric Allergology (. Allergologie select. 2025; 9: 28-39. doi: 10.5414/ALX02531E.

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