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FOAM Bits

Penicillin Anaphylaxis - or why we should fear bedsheets more than meropenem!

28/10/2016

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This excellent post by Josh Farkas from Emcrit.org resumes nicely on how our daily work sometimes is influenced by fears and not knowledge. If you are worried to give a patient meropenem after he had an anaphylactic reaction to penicillin in the past... then this  reading is for you!



His Bottom Line comes as follows:
  • Meropenem doesn’t cause anaphylaxis.
  • Meropenem probably isn’t cross-allergic with penicillin, due to structural differences in its side chains and beta-lactam core.
  • It is widely quoted that patients with penicillin allergy have a ~1% risk of reaction to meropenem. This information is based on non-validated skin testing to meropenem, which is probably incorrect.
  • Prospective studies have proven the safety of giving meropenem to patients with a history of anaphylaxis to penicillin.

Don't miss out this excellent post: PulmCrit mythbusting - Anaphylaxis to penicillins isn’t a contraindication to meropenem

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Coronary Artery Territories

26/10/2016

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This overview comes in very handy when you want to correlate the coronary arteries territories with wall motion abnormalities found on echocardiography.

Thanx to Sam Ghali aka @EM_RESUS for this post on Twitter.
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