@EricMacyMD

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

 San Diego, CA
scholar.google.com/citations?user=b-LM-uEAAAAJ&hl=en
Joined March 2014
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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 jaci-inpractice.org/article/… jaci-inpractice.org/article/… jamanetwork.com/journals/jam…
Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟
@ABsteward8 Jun 2022
Replying to @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
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Evidence Against Use of Nitrogen for the Death Penalty | Neurology | JAMA | JAMA Network jamanetwork.com/journals/jam…
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I poured my heart and soul onto the page and this is the result: doi.org/10.1093/cid/ciae089 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.

The Arrivals Gate at Heathrow Airport

There's a great opening from Richard Curtis' 2003 film Love Actually (arguably one of the best Rom Coms of all time):

academic.oup.com
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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 doximity.com/newsfeed/1e28de… via @doximity
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"Most people who say they are allergic to penicillin,aren't really, and can safely be given pencillins"
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Replying to @ABsteward
Read this amazing article on the dogma of cross reaction sciencedirect.com/science/ar…
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#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
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11 Kaiser Permanente medical centers in Southern California and @KPHawaii received an ‘A’ grade by the @LeapfrogGroup for achieving the highest national standards in patient safety in the Fall 2023 Leapfrog Hospital Safety Grades. Learn more: bit.ly/3soBmAl
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Why words matter; great talk by Aikaterini Anagnostou on translating clinical definitions of #anaphylaxis into patient advice #PAAM2023
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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
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“Penicillin Allergy Evaluation Should Be Performed Proactively in Patients with a Penicillin Allergy Label – A Position Statement of @AAAAI_org Cc @AnaCopaescu @TrubianoJason @EricMacyMD @KimberlyBlumen1 #PALACE #IDXposts aaaai.org/Aaaai/media/Media-…
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(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. sciencedirect.com/science/ar…
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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 jaci-global.org/article/S277…

Fatal ampicillin-sulbactam anaphylaxis in a 34-year-old male

A 34-year-old man receiving his first dose of ampicillin-sulbactam for osteomyelitis in a hospital setting experienced fatal drug-induced anaphylaxis.

jaci-global.org
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The next lowest dose of a beta-lactam inducing fatal anaphylaxis that I could find was in a case report: applications.emro.who.int/em… Intradermal test dosing done with 0.2 ml of 300,000 IU/ml penicillin G or about 36 mg of penicillin.
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Antibiotic Prescribing After Removal of EHR Cephalosporin Warning for Penicillin Allergy jamanetwork.com/journals/jam…

Antibiotic Prescribing After Removal of EHR Cephalosporin Warning for Penicillin Allergy

This cohort study assesses whether removal of a warning against use of cephalosporins in the electronic health record (EHR) of patients with penicillin allergy was associated with changes in the...

jamanetwork.com
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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
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👀💊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
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jaci-inpractice.org/article/…
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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
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New infant fever evaluation tool, called CA FIRST, is set of algorithms offering clinicians help in more scenarios, with fewer interventions. Now in @PermanenteJ from @KPCREST1 collaborators. #pediatrics #hospitalmed @dballard30 @kpnorcal bit.ly/3KC6Ysm
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