Delabelling beta-lactam allergy
Por:
Molina-Molina, GJ, Velandia, DRG, Andres-López, B, Perales, C, Marin-Asensio, L, Jurgens, Y, Esteso, O, Escobar, C, Vidal, X, Vendrell, L, Gómez-Ganda, L, Rodríguez, D, Montané, E, Cardona, V and Agusti, A
Publicada:
27 jun 2024
Resumen:
Background: Hypersensitivity to beta-lactam (BL) antibiotics is one of the most frequent reported drug allergies. In our population, it is common to find labels of BL allergy in electronic medical records (EMRs) that have not been assessed. The objective of our study was to detect patients with beta-lactam allergy labels in their EMRs and to assess how many of them are false after a correct diagnostic evaluation.Methods: A multicentre prospective study was performed with patients labelled as allergic to BLs in their EMRs in the previous 5 years. Demographical and clinical data, as well as variables regarding the BL allergy label and the characteristics of the index reaction from clinical history and EMRs, were recorded. Then, diagnostic assessments including clinical history, skin tests (STs), and drug provocation tests (DPTs) were conducted in order to confirm or exclude the diagnosis of BL allergy.Results: A total of 249 patients completed the study, of which 160 (64.3%) were women with a median age of 57 years (interquartile range [IQR], 45-68). The most frequent BL allergy labels detected were for penicillin (124), amoxicillin/clavulanic acid (61), and amoxicillin (54). Of the 204 patients who underwent STs, 20.1% were positive. DPTs were performed in 224 patients, showing good tolerance in 87.1% of cases. After the allergy diagnosis work-up, 186 patients (74.7%) were diagnosed as non-allergic to BL antibiotics.Conclusion: In our study population, the number of patients labelled as allergic to BLs in their EMRs was similar to that in previously published studies, with proportions near to 75%-80% being falsely labelled as allergic to BLs.
Filiaciones:
Molina-Molina, GJ:
Hosp Univ Bellvitge, Allergy Dept, Lhospitalet De Llobregat, Spain
Velandia, DRG:
Hosp Univ Santa Maria, Allergol Dept, Lleida, Spain
Inst Recerca Biomed Lleida Fundacio Dr Pifarre IRB, Lleida, Spain
Andres-López, B:
Hosp Univ Bellvitge, Allergy Dept, Lhospitalet De Llobregat, Spain
Perales, C:
Hosp Tortosa Verge Cinta, Inst Invest Sanitaria PereVirgili 1, Allergol Sect, Tortosa, Spain
Marin-Asensio, L:
Hosp Tortosa Verge Cinta, Inst Invest Sanitaria PereVirgili 1, Allergol Sect, Tortosa, Spain
Jurgens, Y:
Univ Hosp Germans Trias i Pujol, Allergy Sect, Badalona, Spain
Esteso, O:
Hosp Univ Joan XXIII Tarragona, Allergy Sect, Tarragona, Spain
Escobar, C:
Hosp Univ Dr Josep Trueta, Allergy Dept, Girona, Spain
Vidal, X:
Hosp Univ Vall DHebron, Clin Pharmacol Serv, Barcelona, Spain
Univ Autonoma Barcelona, Dept Pharmacol Therapeut & Toxicol, Barcelona, Spain
Vendrell, L:
Hosp Univ Vall DHebron, Clin Pharmacol Serv, Barcelona, Spain
Univ Autonoma Barcelona, Dept Pharmacol Therapeut & Toxicol, Barcelona, Spain
Vall DHebron Inst Recerca VHIR, Barcelona, Spain
Gómez-Ganda, L:
Hosp Univ Vall DHebron, Pharm Dept, Barcelona, Spain
Rodríguez, D:
Hosp Univ Bellvitge, Clin Pharmacol Serv, Lhospitalet De Llobregat, Spain
:
Univ Autonoma Barcelona, Dept Pharmacol Therapeut & Toxicol, Barcelona, Spain
Univ Hosp Germans Trias I Pujol, Clin Pharmacol Serv, Badalona, Spain
Cardona, V:
Vall DHebron Inst Recerca VHIR, Barcelona, Spain
Hosp Univ Vall DHebron, Dept Allergy, Barcelona, Spain
Agusti, A:
Hosp Univ Vall DHebron, Clin Pharmacol Serv, Barcelona, Spain
Univ Autonoma Barcelona, Dept Pharmacol Therapeut & Toxicol, Barcelona, Spain
gold, Green Published
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