From the Guidelines
If you have a meropenem allergy, you should not use augmentin (amoxicillin-clavulanate) without medical supervision, as cross-reactivity between these beta-lactam antibiotics can occur in approximately 1-10% of patients. These antibiotics belong to different classes - meropenem is a carbapenem while augmentin contains a penicillin. The nature and severity of your previous allergic reaction to meropenem is important information that would help determine your risk, as noted in the 2022 practice parameter update on drug allergy 1. Mild reactions like rashes might allow for cautious use of augmentin under medical supervision, while severe reactions like anaphylaxis would likely prohibit its use entirely.
According to the Dutch Working Party on Antibiotic Policy (SWAB) guideline for the approach to suspected antibiotic allergy, published in 2023 1, the risk of cross-reactivity is smaller than previously assumed, and a structured allergy anamnesis allows clinicians to assess the risk of recurrence of a (severe) allergic reaction. However, the guideline also advises that the avoidance of certain antibiotics in case of suspected true (and severe) antibiotic allergy should be strongly advised.
Before taking augmentin with a meropenem allergy, you should consult with your healthcare provider who can evaluate your specific allergy history, consider alternative antibiotics if needed, or potentially arrange for antibiotic allergy testing to determine if augmentin would be safe for you. The 2022 practice parameter update on drug allergy 1 provides a recommended approach to beta-lactam administration in patients with prior beta-lactam allergies, which can guide healthcare providers in making informed decisions.
Key considerations include:
- The type and severity of the previous allergic reaction to meropenem
- The potential for cross-reactivity between meropenem and augmentin
- The need for medical supervision and potential antibiotic allergy testing
- The importance of evaluating alternative antibiotics if necessary.
From the Research
Meropenem Allergy and Augmentin Use
- The safety of meropenem in patients with a reported penicillin allergy has been studied, and the results suggest that meropenem can be used safely in these patients 2.
- A study published in 2008 found that 110 patients with non-anaphylactic and anaphylactic penicillin allergic reactions tolerated meropenem therapy without any allergic reactions 2.
- Another study published in 2023 found that meropenem allergy assessment can be safely performed at the bedside of hospitalized patients with a reported history of penicillin allergy, and that the use of meropenem can be effective in treating acute infections in these patients 3.
- Regarding the use of Augmentin (amoxicillin/clavulanate) in patients with a meropenem allergy, there is limited information available.
- However, a study published in 2019 found that the risk of cross-reactivity to carbapenems, including meropenem, in patients with a proven penicillin allergy is very low, at 0.87% (95% CI, 0.32-2.32) 4.
- Additionally, a study published in 2022 found that desensitization protocols to beta-lactam antibiotics, including meropenem, can be safe and effective in patients with a confirmed allergy 5.
- It is also worth noting that a study published in 2007 found that meropenem can be safely used in a patient with a possible nonimmediate allergy to imipenem, suggesting that there may be no cross-reactivity between these two carbapenems 6.
Key Findings
- Meropenem can be safely used in patients with a reported penicillin allergy.
- The risk of cross-reactivity to carbapenems, including meropenem, in patients with a proven penicillin allergy is very low.
- Desensitization protocols to beta-lactam antibiotics, including meropenem, can be safe and effective in patients with a confirmed allergy.
- There may be no cross-reactivity between meropenem and imipenem, suggesting that meropenem can be safely used in patients with a possible nonimmediate allergy to imipenem.