Antimicrobial desensitization

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Background

Goal of creating temporary tolerance to an antimicrobial to which the patient has a history of hypersensitivity reaction
Best described for beta-lactam antibiotics with immediate IgE-mediated hypersensitivity reaction
Must carefully evaluate risks and benefits

Procedure

No well-defined universal procedure
Most use a dilution of 0.1% or 1% of therapeutic dose as a continuous infusion (or oral, or subcut), with dose increased steadily over hours to days

Further Reading

Antimicrobial Desensitization: A Review of Published Protocols. Pharmacy (Basel). 2019;7(3):112. doi: 10.3390/pharmacy7030112. PMID: 31405062; PMCID: PMC6789802.

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Procedures