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Table 8.1 Oral ß-lactam desensitisation protocol1

Dose Concentration (mg/mL) Volume (mL) Time Reaction
1 0.1 0.3 0:00  
2 0.1 0.6 0:15  
3 0.1 1.2 0:30  
4 0.1 2.5 0:45  
5 0.1 5 1:00  
6 1 1 1:15  
7 1 2 1:30  
8 1 4 1:45  
9 10 0.8 2:00  
10 10 1.6 2:15  
11 10 3.2 2:30  
12 10 6.4 2:45  
13 100 1.2 3:00  
14 100 2.5 3:15  

 

  1. Prepare stock solution of ß-lactam drug that you wish to use at 100 mg/mL.
  2. Make serial dilutions at 10 mg/mL, 1 mg/mL, 0.1 mg/mL.
  3. Administer doses at 15-minute intervals.
  4. Have epinephrine 1:1,000 on stand-by at bedside.
  5. Once successfully desensitised, begin treatment immediately.
  6. To maintain desensitised state, patient must not interrupt treatment for more than 2 days. Otherwise, patient would need to be desensitised again.

 

Note:

1: Reference: (513)