Eric Macy

Clinical Immunology Allergy. Kaiser Permanente. Drug Hypersensitivity. KPSC IRB Chair.

[Eric Macy @EricMacyMD]

At Kaiser Permanente we have removed all warnings not to use cephalosporins in the setting of a penicillin "allergy", including the very rare history of penicillin-associated anaphylaxis. @KPSCalResearch

https://t.co/bnlTdMFgMH

https://t.co/0v8qvMtOnl

https://t.co/wtvILZrxQW

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

Would love to hear from @EricMacyMD @TrubianoJason @blandman19
Would you consider this case as anaphylaxis with this limited info/time? Do you consider anaphylaxis a reason not to give cefazolin or to be cautious in penicillin allergy? #IDtwitter

[Eric Macy @EricMacyMD]

Evidence Against Use of Nitrogen for the Death Penalty | Neurology | JAMA | JAMA Network https://t.co/r7NDjkVMpw

[Darcy Wooten she/her @Darcy_ID_doc]

I poured my heart and soul onto the page and this is the result:
https://t.co/7F9l4qU6YT

Thank you to @shurtadobares and @PaulSaxMD for giving my voice a space. Thank you to @WendyStead5 and @MikeMeliaMD for the workshop on narrative writing at IDWeek 2023.

[Eric Macy @EricMacyMD]

Perhaps we should change the name of the field in the EHR to WICAs, warnings, intolerances, cautions, and allergies to account for the reasons no to use or reuse a material or drug.

Allergy Lists: Ubiquitous, but Flawed https://t.co/bAx63AKREp via @doximity

[Neil Stone @DrNeilStone]

"Most people who say they are allergic to penicillin,aren't really, and can safely be given pencillins"

[Todd C. Lee @DrToddLee]

@ABsteward Read this amazing article on the dogma of cross reaction

https://t.co/kYfPbgGrAt

[Dr. Atoosa Kourosh, MD, MPH @AllergyHealth]

#ACAAI23 Baseline serum tryptase & #AlphaGal #IgE should be measured in recurring #anaphylaxis & in #biphasic -consider even if #foodAllergy suspected. Educate patients to ask ED for tryptase to be measured in 1st 90 minutes during severe reactions. Criteria for anaphylaxis vary

[Professor Christina Jones @JonesChristinaJ]

Why words matter; great talk by Aikaterini Anagnostou on translating clinical definitions of #anaphylaxis into patient advice #PAAM2023

[Mariam Hanna MD @PedsAllergyDoc]

Corticosteroids (in case you're going to think about it) has ZERO evidence to prevent biphasic reactions.

First generation antihistamines should NEVER be used in the context of anaphylaxis. Stay away! If you're even going to consider it, use 2nd and 3rd generation.

#CSACI23

[United States Drug Allergy Registry @USdrugallergy]

(1/9) The USDAR (United States Drug Allergy Registry) group presents a consensus-developed, standardized, severity grading scale for immediate drug reactions in adults. This scale applies to both clinical care and research. https://t.co/VYU562X2lc

[Eric Macy @EricMacyMD]

The next lowest dose of a beta-lactam inducing fatal anaphylaxis that I could find was in a case report:

https://t.co/WgnfNFfexA

Intradermal test dosing done with 0.2 ml of 300,000 IU/ml penicillin G or about 36 mg of penicillin.

[Eric Macy @EricMacyMD]

An important lesson here. Anaphylaxis occurred with systemic exposure to only about 0.5 mg of ampicillin. ID skin testing (0.02ml) using ampicillin 25 mg/ml.

Use 0.01 molar for beta-lactams.

Fatal ampicillin-sulbactam anaphylaxis in a 34-year-old male
https://t.co/bpVehrnknk

[Eric Macy @EricMacyMD]

Antibiotic Prescribing After Removal of EHR Cephalosporin Warning for Penicillin Allergy https://t.co/aIdVl0q9PJ

[M Louisias MD MPH @MLouisiasMD]

For #PenicillinAllergyDay I want to encourage all our current & future OB/GYNs @acog @ACOGPregnancy to have #allergistimmunologists be a part of the care team for your childbearing & pregnant pts to ensure 1st-line tx for GBS

[Eric Macy @EricMacyMD]

@MalcolmMiller6 email me at [email protected]

[Eric Macy @EricMacyMD]

https://t.co/4dRqWyqrIc

[Kimberly Blumenthal, MD, MSc @KimberlyBlumen1]

👀💊9/28 is National Penicillin Allergy Day! I devoted much of my career to studying the negative impact of taking a reported penicillin allergy as truth and using alternative antibiotics. Some adverse consequences are preventable through penicillin allergy evaluation 1/3

[Kimberly Blumenthal, MD, MSc @KimberlyBlumen1]

Getting ready for National Penicillin Allergy Day de-labeling a patient who is pending cardiothoracic surgery and has a history of penicillin allergy. #NPAD @AAAAI_org @IDSAInfo @SHEA_Epi 1/5