Person: Blumenthal, Kimberly
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Blumenthal
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Kimberly
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Blumenthal, Kimberly
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Publication 745Risk of Peripheral Blood Eosinophilia and Hypersensitivity Reactions among Patients Receiving Outpatient Parenteral Antibiotics(Oxford University Press, 2014) Blumenthal, Kimberly; Youngster, Ilan; Parker, Robert; Walensky, Rochelle; Nelson, SandraPublication Ceftaroline Desensitization Procedure in a Pregnant Patient With Multiple Drug Allergies(Oxford University Press, 2015) Kuhlen, James L.; Blumenthal, Kimberly; Sokol, Caroline; Balekian, Diana S.; Weil, Ana; Varughese, Christy A.; Seiguer Shenoy, Erica; Banerji, AleenaValidated skin testing is lacking for many drugs, including ceftaroline. The cross-reactivity between ceftaroline and other β-lactam antibiotics is unknown. We report a case of a pregnant patient with cystic fibrosis and multiple drug allergies who required ceftaroline for methicillin-resistant Staphylococcus aureus pneumonia and underwent an uncomplicated empiric desensitization procedure.Publication The Impact of Reporting a Prior Penicillin Allergy on the Treatment of Methicillin-Sensitive Staphylococcus aureus Bacteremia(Public Library of Science, 2016) Blumenthal, Kimberly; Seiguer Shenoy, Erica; Huang, Mingshu; Kuhlen, James L.; Ware, Winston A.; Parker, Robert; Walensky, RochelleBackground: Methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia is a morbid infection with mortality benefit from receipt of parenteral β-lactam therapy. A substantial portion of MSSA bacteremia patients report penicillin allergy, but infrequently have true allergy. Objective: To determine the frequency and predictors of optimal and adequate therapy in patients with MSSA bacteremia. Design: Retrospective cohort. Participants: Adult inpatients with MSSA bacteremia, January 2009 through October 2013. Main Measures The primary measure was a trial of optimal therapy (OT), defined as ≥3 inpatient days or discharge on any first-line agents (nafcillin, oxacillin, cefazolin, or penicillin G, if susceptible). The secondary measure was completion of adequate therapy (AT), defined as ≥10 inpatient days or discharge on an agent appropriate for MSSA bacteremia. Data were electronically gathered with key variables manually validated through chart review. Log-binomial regression models were used to determine the frequency and predictors of outcomes. Key Results Of 456 patients, 346 (76%) received a trial of OT. Patients reporting penicillin allergy (13%) were less likely to receive OT trial than those without penicillin allergy (47% vs. 80%, p <0.001). Adjusting for other factors, penicillin allergy was the largest negative predictor of OT trial (RR 0.64 [0.49, 0.83]). Infectious Disease (ID) consultation was the largest positive predictor of OT trial across all patients (RR 1.34 [1.14, 1.57]). Allergy/Immunology consultation was the single most important predictor of OT trial among patients reporting penicillin allergy (RR 2.33 [1.44, 3.77]). Of 440 patients, 391 (89%) completed AT, with ID consultation the largest positive predictor of the outcome (RR 1.28 [1.15, 1.43]). Conclusions: Nearly 25% of patients with MSSA bacteremia did not receive OT trial and about 10% did not receive AT completion. Reported penicillin allergy reduced, and ID consult increased, the likelihood of OT. Allergy evaluation, coupled with ID consultation, may improve outcomes in MSSA bacteremic patients.Publication Treatment Outcomes and Adverse Drug Reactions Associated with Ceftaroline Use(Oxford University Press, 2015) Blumenthal, Kimberly; Kuhlen, James; Weil, Ana; Varughese, Christy; Kubiak, David W.; Banerji, Aleena; Seiguer Shenoy, Erica