Standards for practical management of drug hypersensitivity reactions to intravenous drugs and proactive early allergy involvement before referral: A WAO Statement
Year: 2026
Type: article
Abstract: Hypersensitivity reactions to intravenous therapies-including antibiotics, chemotherapeutics, biologics, anesthesia agents, and contrast media-pose significant challenges in acute care settings. These reactions often occur outside the purview of allergy specialists, leading to delays in recognition, suboptimal management, and inconsistent documentation. This article underscores the imperative for proactive, multidisciplinary collaboration to enhance patient safety and treatment continuity. We examine the spectrum of intravenous reactions, including anaphylaxis, highlighting the pivotal role of allergists in both acute intervention and long-term care planning. Emphasis is placed on the development of standardized protocols, the establishment of inpatient allergy consult teams, and the implementation of penicillin allergy delabeling strategies. Supplemental materials provide real-world examples from leading institutions that have successfully integrated multidisciplinary approaches, demonstrating improved outcomes through coordinated care. By proactively engaging in the creation of safety protocols, referral pathways, and joint models of care, allergy specialists can contribute significantly to safer patient environments, even before reactions occur, ensuring timely diagnosis, effective management, and optimal outcomes.
Authors: Ricardo Madrigal-Burgaleta, Emilio Alvarez-Cuesta, Knut Brockow, Jean-Christoph Caubet, Lene H. Garvey, Antonieta Guzman-Melendez, Marina Labella Alvarez, Lina Mayorga, Paula Vazquez-Revuelta, Ignacio J. Ansotegui, Marina Attanasi, Marcelo Vivolo Aun, Joan Bartra, Sevim Bavbek, Maria Pilar Berges-Gimeno, Lorena Bernal-Rubio, Cosmin Boteanu, Lucrecia Bustamante, Carlo Caffarelli, Timothy G. Chow, Bryan N. Fernandes, Pedro Giavina-Bianchi, David Khan, Semanur Kuyucu, Jose Julio Laguna, Jonathan Lambourne, Lily Li, Susana Marinho, Francesca Mori, Allison E. Norton, Valeria Palma Pino, Claudio A.S. Parisi, Hae-Sim Park, Elizabeth Powell, Eva Rebelo Gomes, Antonino Romano, Marek Sanak, Rik Schrijvers, Emilio Solano-Solares, Luciana Kase Tanno, Rocco Luigi Valluzzi, Rosalaura Villarreal-Gonzalez, Timothy J. Watts, Andrew A. White, Masao Yamaguchi
Institutions: St Bartholomew's Hospital, Barts Health NHS Trust, Hospital Universitario Ramón y Cajal, Technical University of Munich, University of Geneva, University Hospital of Geneva, University of Copenhagen, Copenhagen University Hospital, Gentofte Hospital, Hospital Clínico de la Universidad de Chile, University of Chile, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Andalusian Centre for Nanomedicine and Biotechnology, Bellvitge University Hospital, Institut Català d'Oncologia, Universitat de Barcelona, IDCQ Hospitales y Sanidad, S.L.U., University of Chieti-Pescara, Universidade de São Paulo, Hospital Israelita Albert Einstein, Instituto de Salud Carlos III, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Ankara University, Instituto Cajal, Universidad Alfonso X el Sabio, Hospital Italiano de Buenos Aires, University of Parma, The University of Texas Southwestern Medical Center, Mersin Üniversitesi, University of Washington, University of Manchester, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Meyer Children's Hospital, Vanderbilt University, Ajou University, Guy's and St Thomas' NHS Foundation Trust, Evelina London Children's Healthcare, Hospital de Santo António, Jagiellonian University, KU Leuven, Inserm, Centre Hospitalier Universitaire de Montpellier, Bambino Gesù Children's Hospital, Istituti di Ricovero e Cura a Carattere Scientifico, Universidad Autónoma de Nuevo León, Hospital Universitario Dr José Eleuterio Gonzalez, Scripps Health, Scripps Clinic, Teikyo University Chiba Medical Center
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,508
OpenAlex ID: W7214338372