{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T22:28:46Z","timestamp":1787956126149,"version":"build-2784847793"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"unspecified","delay-in-days":85,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2732494X26103222_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Piperacillin\u2013tazobactam is a beta-lactam antibiotic with a distinct R1 side chain compared to other penicillins, therefore the risk of cross-reactivity should be theoretically low. Despite this difference, antimicrobial guidelines recommend against using piperacillin\u2013tazobactam in patients with penicillin allergies. There is limited data available regarding piperacillin\u2013tazobactam use in patients with a penicillin allergy, or rates of cross-reactivity. Therefore, the objective of this study was to assess the incidence of cross-reactivity to piperacillin\u2013tazobactam in patients with a labeled penicillin allergy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26103222_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This was a retrospective study of patients admitted to Surrey Memorial Hospital (SMH) between November 1\n                      <jats:sup>st<\/jats:sup>\n                      , 2021 to January 31\n                      <jats:sup>st<\/jats:sup>\n                      , 2024 assessing tolerance to piperacillin\u2013tazobactam in patients with prior labeled penicillin allergies. Baseline characteristics and outcomes were collected from electronic medical records (EMR).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26103222_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 191 patients included, 98% were found to tolerate one or more doses of piperacillin\u2013tazobactam. This included 95 patients with \u201clow risk delayed reactions,\u201d 90 patients with \u201chigh risk anaphylactic reactions,\u201d and 2 patients with \u201cwell-documented delayed reactions,\u201d to penicillins. Only four patients out of 191 had documented intolerance to piperacillin-tazobactam post-exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26103222_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study suggests that piperacillin\u2013tazobactam has a low risk of intolerability (2%) in patients with labeled penicillin allergies, and that it is reasonable to consider piperacillin\u2013tazobactam as an alternative to carbapenems and other broad-spectrum antibiotics for most patients with a previous penicillin allergy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ash.2026.10322","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:38:41Z","timestamp":1774611521000},"source":"Crossref","is-referenced-by-count":1,"title":["Piperacillin\u2013tazobactam tolerability in patients with a labeled penicillin allergy (PIPPEN)"],"prefix":"10.1017","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5486-9146","authenticated-orcid":false,"given":"Avneet","family":"Purewal","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014579w63","id-type":"ROR","asserted-by":"publisher"}],"name":"Fraser Health Authority"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8047-8633","authenticated-orcid":false,"given":"Kieran","family":"Shah","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014579w63","id-type":"ROR","asserted-by":"publisher"}],"name":"Fraser Health Authority"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5296-3261","authenticated-orcid":false,"given":"Sarah N.","family":"Stabler","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014579w63","id-type":"ROR","asserted-by":"publisher"}],"name":"Fraser Health Authority"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9900-4674","authenticated-orcid":false,"given":"Kevin","family":"Afra","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014579w63","id-type":"ROR","asserted-by":"publisher"}],"name":"Fraser Health Authority"},{"id":[{"id":"https:\/\/ror.org\/03rmrcq20","id-type":"ROR","asserted-by":"publisher"}],"name":"The University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9503-7137","authenticated-orcid":false,"given":"Ke","family":"Su","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014579w63","id-type":"ROR","asserted-by":"publisher"}],"name":"Fraser Health Authority"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"S2732494X26103222_ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s13223-020-00494-2"},{"key":"S2732494X26103222_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.05.038"},{"key":"S2732494X26103222_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2020.12.051"},{"key":"S2732494X26103222_ref10","unstructured":"10. ASP Handbook. Penicillin allergies \u2013 guide for clinicians [Internet]: Fraser Health [updated June 13, 2018]. https:\/\/pulse\/clinical\/antimicrobial-stewardship\/Documents%20%20ASP%Handbook-%20Penicillin%20Allergies%20%282018-06-13%29.pdf. Accessed July 6, 2023"},{"key":"S2732494X26103222_ref14","unstructured":"14. Public Health Agency of Canada. Canadian antimicrobial resistance surveillance system report 2021[Internet]. Government of Canada, 2022. https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/drugs-health-products\/canadian-antimicrobial-resistance-surveillance-system-report-2021.html#a53. Accessed July 6, 2023"},{"key":"S2732494X26103222_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.08.021"},{"key":"S2732494X26103222_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2014.02.005"},{"key":"S2732494X26103222_ref9","unstructured":"9. Bugs and Drugs, AB Canada; Alberta Health Services. \u03b2-lactam cross-reactivity chart, 2023. https:\/\/bugsanddrugs.org\/8dbf3d51-1be5-4669-be8e-679fd1564cd6. Accessed July 6, 2023"},{"key":"S2732494X26103222_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2022.21"},{"key":"S2732494X26103222_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2020.04.008"},{"key":"S2732494X26103222_ref5","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S242061"},{"key":"S2732494X26103222_ref13","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.2986"},{"key":"S2732494X26103222_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.08.027"},{"key":"S2732494X26103222_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2022.08.028"},{"key":"S2732494X26103222_ref6","doi-asserted-by":"publisher","DOI":"10.18773\/austprescr.2019.065"},{"key":"S2732494X26103222_ref16","unstructured":"16. American College of Allergy, Asthma & Immunology. Drug allergies: Reactions, symptoms & treatment [Internet], 2022 [cited July 30, 2023]. https:\/\/acaai.org\/allergies\/allergic-conditions\/drug-allergies\/."},{"key":"S2732494X26103222_ref2","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2021.13.2.284"}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X26103222","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:38:44Z","timestamp":1774611524000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X26103222\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S2732494X26103222"],"URL":"https:\/\/doi.org\/10.1017\/ash.2026.10322","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e68"}}