A review of professional liability when prescribing beta-lactams and the contributions and life of Henry Claman, MD

November 26, 2018

As we return to work after our holiday weekend celebrating Thanksgiving, our minds are still full of gratitude for our family and friends we’ve spent time with. Hopefully, you’ll now have an opportunity to peruse the November Annals of Allergy, Asthma and Immunology issue either online or in print. The emphasis for this month’s issue is penicillin allergy, an important and timely topic.

An article that is a must-read for every clinician who proposes to use a beta-lactam containing antibiotic (such as cephalosporins and carbapenems) in penicillin-allergic patients is a systemic review of professional liability when prescribing beta-lactams by Meghan Jeffres, PharmD, Elizabeth Hall-Lipsy, JD, MPH, and colleagues. In many instances, colleagues opt to use non-beta-lactam antibiotics in patients self-described as penicillin allergic and especially in those with known penicillin allergy. This leads to higher costs, complications and, in many instances, decreased therapeutic effectiveness. Litigation fear is voiced as a common reason for this practice by many providers. This systematic review of reported malpractice case results suggests that such fears may be largely unfounded as judges often cite lack of scientific evidence linking penicillin allergy and systemic reactions to non-penicillin beta-lactam containing drugs. This article provides thought-provoking information for us and our non-allergist colleagues as we spread the word that appropriate penicillin testing can help protect patients by not denying them the use of an effective beta-lactam drug.

We have other features in this month’s issue that will interest and inform you as well. In particular is our latest installment in our “Giants in Allergy and Immunology” series. This article describes the significant scientific contributions of Henry Claman, MD, and is authored by a former mentee and colleague, Stephen Dreskin, MD, PhD. Dr. Claman was a pioneer in immunology, being one of the first to ascribe distinct functions of B and T cells to the small lymphocytes that looked very much the same under a microscope. This was all done during a time when the technology of immunology was in its absolute infancy. Dr. Dreskin goes on to describe Dr. Claman the man as well as the physician-scientist. It makes for a good read and introduces us to the human side of another giant in our field.

As we continue in our quest to provide the most scientifically sound, clinically useful information possible to you, the entire editorial staff, editors and I all wish you a wonderful holiday season and great success and satisfaction in this passion we call allergy/immunology. Comments, suggestions and other input are always welcome.

Gailen Marshall Jr., MD, PhD, FACAAI