ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2026
Piperacillin-tazobactam tolerability in patients with a labeled penicillin allergy (PIPPEN).
Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Background: Piperacillin-tazobactam 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-tazobactam in patients with penicillin allergies. There is limited data available regarding piperacillin-tazobactam 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-tazobactam in patients with a labeled penicillin allergy. Methods: This was a retrospective study of patients admitted to Surrey Memorial Hospital (SMH) between November 1 Results: Of the 191 patients included, 98% were found to tolerate one or more doses of piperacillin-tazobactam. This included 95 patients with "low risk delayed reactions," 90 patients with "high risk anaphylactic reactions," and 2 patients with "well-documented delayed reactions," to penicillins. Only four patients out of 191 had documented intolerance to piperacillin-tazobactam post-exposure. Conclusion: This study suggests that piperacillin-tazobactam has a low risk of intolerability (2%) in patients with labeled penicillin allergies, and that it is reasonable to consider piperacillin-tazobactam as an alternative to carbapenems and other broad-spectrum antibiotics for most patients with a previous penicillin allergy.
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