Kimberly Blumenthal, MD, MSc Profile picture
Sep 27, 2022 8 tweets 13 min read Read on X
Tomorrow is #NationalPenicillinAllergyDay in the US! In advance of that, I will share some of my favorite resources on #penicillin #allergy. Please share these broadly with your networks. We have >30mil Americans to evaluate... let's get started! #NPAD 1/7 Image
@MGHAllergy has hosted a multi-site network called @USdrugallergy since 2017 and we have 7 engaged sites with 1,796 enrolled. On our website usdar.massgeneral.org we have @YouTube videos on #drugallergy and #penicillin allergy and post our latest research findings! 2/7
@AAAAI_org has a penicillin allergy center with easy links to educational videos and infographics. Educate yourself and your patients. Increase awareness with images for social media @allisoncramsey @AutumnGuyer education.aaaai.org/penicillin-all… 3/7 Image
@JAMA_current has 7.0 CME credits on #penicillin allergy endorsed by @IDSAInfo , @SHEA_Epi , and @AAAAI_org . The toolkits help with allergy history, diagnostic testing, and anaphylaxis kits. @EricMacyMD @ericashenoy There is also a video: 4/7 Image
@JAMA_current and @JAMAPediatrics also have 3 patient education pages for general, pediatrics, and obstetrics. These are gorgeous and ready for posting in your clinics! 5/7 Image
@JACIInPractice #drugallergy theme issue has a video on @YouTube that shows you how to do immediate hypersensitivity testing to #PENICILLIN . Check out how we do it @vumc_cdsi_rsch @MGHAllergy 6/7 Image
Let’s address unverified penicillin allergy labels even when not the reason for presentation. Let’s devise ways to help hospitals and communities expand services. Let’s raise awareness. Together, we can reduce the harms associated with unverified penicillin allergies. #NPAD 7/7

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More from @KimberlyBlumen1

Apr 20, 2023
I am going to write part of my (unfinished) story about the K to R transition as a woman in medicine and physician scientist in a multi-disciplinary research space in a tumultuous time. I am oversharing to encourage others in a similar 🚤#medtwitter #IDTwitter #AIMedEd. /1 of 20
I study #drug #allergy. It was the inferior antibiotic choices we made for people with vague antibiotic allergies during my residency @MGHMedicine @mghmedres that initially gave me the idea. Too often the allergy lists were impeding clinical care. /2 of 20
I hypothesized that drug allergies were a problem -- that penicillin allergies alone were linked to important antibiotic stewardship and public health outcomes. I set off to prove this, and address the burden of unclear drug allergies across populations. /3 of 20
Read 21 tweets
Sep 24, 2022
1 of 10 /Do you use an electronic health record? Did anyone ever teach you how to document #allergies? 👀Check our this #EHR allergy documentation guidance #medtwitter #idtwitter #AIMedEd @EricMacyMD @AutumnGuyer @allisoncramsey @vumc_cdsi_rsch @JACIInPractice
2 of 10/We are excited to announce that the adverse reaction to drugs biologics and latex (ARDBL) committee of the @AAAAI_org has an #inpress workgroup report on allergy documentation in the EHR. jaci-inpractice.org/article/S2213-…
3 of 10/ In this article: current state of allergy #ehr documentation, definitions, reconfigurations, and recommendations✔️#bestpractices in documentation for #penicillin allergy ✔️what to include and what not to include in the allergy list
Read 11 tweets
Mar 5, 2022
We allergists have historically considered the risk of “cross reaction” between FQs ~30%. These are great new real-world data with a practical inpatient application for individuals with a FQ allergy label and rxn suggestive of immediate HSR. @PaulSaxMD @BrianTanChan /1
This study is unlikely to be capturing true “cross reaction” rate because these individuals did not have a confirmed FQ immediate hypersensitivity and there is likely a natural selection bias with respect to which patients were challenged to another FQ and which were not. /2
The prospective observational study that is the largest I know of evaluated patients a median on 9.5 months after their FQ rxn and prospectively assessed “cross reaction” with single blind placebo controlled challenges and the rates were higher : pubmed.ncbi.nlm.nih.gov/28497922/ 3
Read 6 tweets
Dec 11, 2021
⭐️FIVE Little Allergy/Immunology Lessons from 5 Big Days on Consults ⭐️ @mghaifellows @MGHAllergy. #Urticaria #Angioedema #vaccine reactions eosinophilia and #drugallergy /1
ONE-To treat acute urticaria (hives), antihistamines should be nonsedating and scheduled (not diphenhydramine PRN). Allegra/fexofenadine and Zyrtec/cetirizine have large therapeutic windows and are used safely at 4+ times the daily allergic rhinitis dose/2
TWO-Angioedema in an adult without skin itching/hives/rash—check if they on an ACE inhibitor! Although ~10% get it w/in 30d, many happen after years of uneventfully being on it /3 ncbi.nlm.nih.gov/pmc/articles/P…
Read 8 tweets
Mar 8, 2021
🧵1/ prospective cohort @JAMANetwork >64K employees receiving @pfizer @moderna_tx #CovidVaccine dose 1, 98% had no allergy symptoms, 2% had some allergy symptoms (itching/rash/hives/swelling) & #anaphylaxis occurred 2.47/10K vaccinations. jamanetwork.com/journals/jama/…
2/Allergy symptoms were slightly more with @moderna_tx (2.20% vs 1.95%; p=0.03). Although no difference in #anaphylaxis incidence by vaccine manufacturer, but different #anaphylaxis criteria led to different estimates (Brighton/NIAID/FAAN: from 1.1-2.5/10K administrations).
3/Similar to @CDCgov reports, the 16 #anaphylaxis patients were largely female (94%); 10 (63%) had prior allergy history and 5 (31%) had prior anaphylaxis history. BUT, we estimate that ~4K @MassGenBrigham employees with severe allergy histories were safely vaccinated.
Read 7 tweets
Jan 13, 2021
1/Brief #COVID19vaccine allergy update: LARGE LOCAL REACTIONS! These all were after #Moderna. Itchy, swollen, erythema, edema. Comes on late (>5 days) and can last weeks .Tx is symptomatic: antihistamine (e.g., fexofenadine), NSAID/Tylenol, ice. ImageImageImageImage
2/ Importantly, you CAN still get the second dose! In the #modernavaccine trial, delayed large locals like these occurred 4x less with 2nd dose than 1st dose. Fewer large locals AND more efficacy, sign me up!
Read 4 tweets

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