A clinical decision-making algorithm for penicillin allergy

Soria, Angèle; Autegarden, Élodie; Amsler, E.; Gaouar, H.; Vial, Annemiek; Françès, Camille; Autegarden, Jean‐Eric

doi:10.1080/07853890.2017.1370125

Cited by 23 publications

(20 citation statements)

References 31 publications

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“…Nevertheless, according to some studies 77,84,86,95,97,98,103,107,108 (b) Some groups consider the tolerance of a MSUD or DTD enough to exclude a delayed hypersensitivity. 18,29,73,74,80,87,89,92,93,97,98,103,[106][107][108] In the related studies, 18,29,73,74,80,87,89,92,93,97,98,103,[106][107][108] the rate of positive responses to DPT with suspected BL ranged from 0% 29,89 to 7.7%. 106 Other groups believe that a too short exposure to BL (in terms of days) can be responsible for false-negative DPT, this being the rationale for performing DPT with a duration of 2-5 days [69][70][71][75][76]…”

Section: Drug Provocation Testsmentioning

confidence: 94%

“…The clinical history is not reliable as a diagnostic tool (high/strong) and predictive models, as well as clinical decision‐making algorithms, based on the clinical history of patients with suspicions of allergic reactions to BL have proved to be unable to accurately differentiate between allergic and nonallergic individuals (moderate/strong) . Confirmation or exclusion of BL allergy is mainly based on skin tests (ST), patch tests (PT), and drug provocation tests (DPT) (high/strong).…”

Section: Diagnosismentioning

confidence: 99%

“…During the last decade, DPT with the suspected BL have been performed in series larger than 100 subjects involving either pediatric or adult populations or both, highly enhancing our knowledge on the usefulness and safety of this diagnostic tool in BL allergy workup. This knowledge has contributed to achieving agreement on several areas of the general principles for DPT (high/strong) (Table ).…”

Section: Diagnosismentioning

confidence: 99%

“…(b) Some groups consider the tolerance of a MSUD or DTD enough to exclude a delayed hypersensitivity . In the related studies, the rate of positive responses to DPT with suspected BL ranged from 0% to 7.7% …”

Section: Diagnosismentioning

confidence: 99%

See 3 more Smart Citations

Towards a more precise diagnosis of hypersensitivity to beta‐lactams — an EAACI position paper

Romano

Atanasković-Marković

Barbaud

et al. 2020

Allergy

251

373

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A recent survey of the European Academy of Allergy and Clinical Immunology (EAACI) Drug Allergy Interest Group (DAIG) on how European allergy specialists deal with betalactam (BL) hypersensitivity demonstrated a significant heterogeneity in current practice, suggesting the need to review and update existing EAACI guidelines in order to make the diagnostic procedures as safe and accurate, but also as cost-effective, as pos-Mono

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Section: Drug Provocation Testsmentioning

confidence: 94%

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

Towards a more precise diagnosis of hypersensitivity to beta‐lactams — an EAACI position paper

Romano

Atanasković-Marković

Barbaud

et al. 2020

Allergy

251

373

View full text Add to dashboard Cite

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“…Métodos: Foram avaliados os processos clínicos dos doentes que recorreram à consulta de Imunoalergologia por suspeita de alergia medicamentosa com estudo alergológico concluído entre janeiro de 2017 e junho de 2018. Foram A fórmula usada no cálculo da probabilidade a priori do diagnóstico foi: Por seu lado, Soria A. et al 13 propõem também um algoritmo para a alergia à penicilina baseado em árvores de decisão, que revela um baixo risco de erro na classi-…”

Section: Artigo Originalunclassified

Análise de um modelo preditivo para o diagnóstico de alergia a fármacos baseado na história clínica

Cardoso¹,

Farinha²,

Martins³

et al. 2020

rpia

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8,4 a 96,4%) para o grupo dos não alérgicos, não se encontrando um limiar com bom poder discriminativo entre as duas situações (curva ROC). Conclusões: O modelo testado revelou um mau desempenho nesta população, sugerindo que os modelos preditivos necessitam de aperfeiçoamento para virem a ser uma ferramenta útil no estudo alergológico das reações a fármacos.Palavras -chave: Alergia a fármacos, hipersensibilidade a fármacos, estudo alergológico, modelos preditivos, algoritmos de decisão. ABSTRACTBackground: Allergic drug reactions represent an important public health problem associated with a significant mortality and morbidity. The allergy workup in this situation is expensive and time consuming. A predictive model using medical history would allow us to assess the risk of a positive result and might simplify the diagnostic process. Aims: To assess the performance of the Hierro Santorino predictive model in patients from our Immunoallergology department investigated for drug allergy. Methods: We included in our study patients referred to our department for drug allergy whose investigation was concluded between January 2017 and June 2018. We collected clinical data identified as the predictive factors in the mentioned model, as well as the results from the allergy work up. The Hierro Santorino model was then applied to our population and its performance was evaluated. Results: We analyzed 159 cases corresponding to 143 patients, 54 (37.8%) females, mean age of 42.1 ± 25.4 years.In 108 cases there was only 1 drug involved. In 39% of the cases a beta -lactam was the suspected drug, in 31% a nonsteroidal anti -inflammatory drug (NSAID) and in 29.6% other drug classes were suspected. In 18.2% of the cases the final diagnosis was positive for drug allergy, in 15.7% "NSAID intolerance" was established, 5% of the patients had "angiotensin -converting -enzyme inhibitor intolerance" and in 54.1% drug allergy was excluded. As the model under study was applied the mean probability of drug allergy was 73.3% (26.6% to 91.7%) in the allergic group and 68. 7% (8.4% to 96.4%) in the non -allergic group. There was no cut -off value with capacity to discriminate between the outcomes. Conclusions: The model tested in our population revealed a poor performance suggesting that predictive models still need improving to be used as a tool in the allergy workup.

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Immediate and Delayed Reactions to Beta-Lactams

Jaén

Veguillas

2022

Drug Eruptions

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A clinical decision-making algorithm for penicillin allergy

Cited by 23 publications

References 31 publications

Towards a more precise diagnosis of hypersensitivity to beta‐lactams — an EAACI position paper

Towards a more precise diagnosis of hypersensitivity to beta‐lactams — an EAACI position paper

Análise de um modelo preditivo para o diagnóstico de alergia a fármacos baseado na história clínica

Immediate and Delayed Reactions to Beta-Lactams

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