Diagnosis of Immediate Hypersensitivity to β-Lactam Antibiotics Can Be Made Safely with Current Approaches

Çelik, Gülfem; Aydın, Ömür; Doğu, Figen; Çipe, Funda; Boyvat, Ayşe; İkincioğulları, Aydan; Akyol, Aynur; Demirel, Yavuz

doi:10.1159/000328212

Cited by 19 publications

(13 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar to other studies [3, 29, 30, 31], we had a predominance of female being evaluated 85/124 (68.5%), with similar rates of confirmed drug hypersensitivity between both sexes and similar age differences.…”

Section: Discussionsupporting

confidence: 88%

“…This is relatively high percentage of positivity, and different from the usual reported 10% [1, 2, 5, 6]. However, similar rates of positivity were reported in a study from Turkey (36.2%) [31]. Our confirmed high numbers could be even underestimated as anaphylactic patients were not included.…”

Section: Discussionsupporting

confidence: 63%

“…Compared with other studies with skin testing to PPL, MDM, Penicillin G, and Amoxicillin, where DPT was needed in 4.3% [35], 7.2% [34], 7.7% [32], 16.9% [36], and 17.2% [31] of patients.…”

Section: Discussionmentioning

confidence: 95%

See 2 more Smart Citations

Penicillin allergy evaluation: experience from a drug allergy clinic in an Arabian Gulf Country, Kuwait

Al‐Ahmad¹,

Bouza²,

Arifhodžić³

2014

Asia Pacific Allergy

View full text Add to dashboard Cite

BackgroundHypersensitivity to penicillin has been studied worldwide, but data regarding patterns of sensitization in Arabian Gulf countries are scarce.ObjectiveTo describe the patterns of penicillin hypersensitivity during a 6-year study in Kuwait in terms of demographics, type of the culprit drug, in vivo and in vitro allergy testing.MethodsOne hundred and twenty-four patients referred to the drug allergy clinic for penicillin allergy were fully evaluated by skin prick and intradermal testing. Drug provocation test was done on patients with negative results.ResultsA total of 124 patients were evaluated for penicillin allergy. Mean age was 37.8 (standard deviation, 12.7) years, range from 8 to 74 years. Thirty-nine male (31.5%) and 85 female patients (68.5%) were included. Diagnosis of penicillin allergy was confirmed in 46 patients (37.1%). Among the 44 confirmed allergic patients by skin evaluation we had 15 (34.1%) positive skin prick test, and 29 (65.9%) positive intradermal testing. Among patients with positive skin testing, 47.7% were positive to major determinant benzylpenicilloyl poly-L-lysine, 20.4% to minor determinant mixture, 50.0% to penicillin G and 40.9% to ampicillin; 13.6% of patients were positive to amoxicillin by skin prick test. One patient had a positive radioallergosorbent test and one had a positive challenge test.ConclusionPenicillin allergy is a common problem with an incidence of about one third in our study subjects.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 63%

See 1 more Smart Citation

Penicillin allergy evaluation: experience from a drug allergy clinic in an Arabian Gulf Country, Kuwait

Al‐Ahmad¹,

Bouza²,

Arifhodžić³

2014

Asia Pacific Allergy

View full text Add to dashboard Cite

show abstract

“…Svi pacijenti kojima je od strane alergologa bilo indikovano testiranje na penicilin (ciljano) ili kao terapijska alternativa kod preosetljivosti na druge grupe antibiotika, su testirani, iako 13.5% pacijenata nije navodilo prisustvo alergije na penicilin u anamnezi. Kao i u drugim studijama (12)(13)(14)(15)(16), i u našoj su među testiranima bile brojnije žene 59/81. Pacijenti kojima je potvrđena preosetljivost na peniciline su različitog pola i uzrasne grupe.…”

Section: Diskusijaunclassified

Penicillin allergy evaluation: Experience from Clinic of Allergology and Immunology, Clinical Center of Serbia

Kuŝic̀¹,

Spirić²

2018

Medicinski podmladak

View full text Add to dashboard Cite

Introduction: Beta(β)-lactam antibiotics are one of the most prescribed medical drugs worldwide. The incidence of self-reported penicillin allergy ranges from 1 to 10 percent. Patients with registered allergy on β-lactam antibiotics are treated with drugs of second choice which are usually more toxic and more expensive. Aim: The aim of this study was to exam the prevalence of penicillin allergy and correlation of clinical, laboratory and socio-demographic characteristic of patients with and without hypersensitivity to penicillin which were available in medical records. Material and methods: This retrospective, descriptive study included consecutive patients, which were treated in Clinic of Allergology and Immunology, Clinical Center of Serbia (CCS), in the period between the years 2010-2015. Anamnestic data of patients with self-reported allergic reaction to penicilin and the rest of β-lactam antibiotics were used, as well as results of in vivo and in vitro tests. Results: 81 patients were evaluated in the study, of which 59 (72.8%) were females. The average age of patients was 41.7±16.47 years. Adverse effects to penicillin were reported by 70/81 (86.4%) tested patients. In accordance with other studies, the most common initial symptoms were rash (exanthema) and angioedema. None of the 70 patients with selfreporetd allergic reaction to penicillin had positive in vitro tests. Total number of patients with positive in vivo tests is 2/81 (2.5%) Conclusion: Despite a small percentage of positive penicillin hypersensitivity tests of patients with anamnestic data of self-reported allergic reaction, it is necessary to perform in vivo drug provocation test as a gold standard for confirmation of penicillin hypesensitivity in order to reduce the utilization of alternative antimicrobial drugs, the risk of microbial resistance and treatment costs.

show abstract

“…their symptoms are consistent with a viral illness instead. Hence, they could be safely treated with ² -lactam antibiotics in the future [4]. Determining the exact prevalence of ² -lactam antibiotic allergies with confirmatory tests such as skin testing and challenges is crucial to establishing the burden of this allergy within the population.…”

Section: Introductionmentioning

confidence: 99%

Positive penicillin allergy testing results: a systematic review and meta-analysis of papers published from 2010 through 2015

Harandian

Pham

Ben‐Shoshan

2016

Postgraduate Medicine

View full text Add to dashboard Cite

β-lactam antibiotics are the most widely used group of antibiotics, given their effectiveness for the most common bacterial pathogens and their relatively low price. Adverse reactions, mainly cutaneous, are often reported to be associated with their use and hence, less effective and usually more costly alternative antibiotics are prescribed. However, it is not clear what is the risk of immediate immune-mediated (i.e. developing within one hour of administration) and potentially life-threatening reactions among those using β-lactam antibiotic. We conducted a systematic review to assess the prevalence of immediate adverse reactions to β-lactam antibiotics, specifically penicillin derivatives, in patients with a reported adverse reaction to β-lactam antibiotics. In addition, we determined the effect of age on the prevalence of immediate reactions. Assessing the true risk of using β-lactam antibiotics in patients with a reported allergy could prevent physicians from unnecessarily discouraging the use of β-lactam antibiotics. We conducted a systematic review and a meta-analysis using the PubMed, OVID, and Embase databases of work published in English and in French in the last 5 years. Studies were only eligible if they established the prevalence of immediate penicillin reactions with skin testing or challenges in case of negative skin tests. The meta-analysis was conducted using Stata version 12.0. The prevalence of immediate reactions to penicillin derivatives in patients reporting a β-lactam hypersensitivity is 1.98% (95%CI; 1.35%, 2.60%) in the pediatric (under 18 years old) group, 7.78% (95%CI; 6.53%, 9.04%) in the adult group, and 2.84% (95%CI; 1.77%, 3.91%) in the combined group, as tested in various studies, using skin tests and oral challenges. The I(2) value ranged between 87.2% and 97.0%. Our results indicate that the prevalence of immediate reactions is higher in adults than in children. However, wide confidence intervals and a large study heterogeneity preclude conclusive estimates.

show abstract

Diagnosis of Immediate Hypersensitivity to β-Lactam Antibiotics Can Be Made Safely with Current Approaches

Cited by 19 publications

References 56 publications

Penicillin allergy evaluation: experience from a drug allergy clinic in an Arabian Gulf Country, Kuwait

Penicillin allergy evaluation: experience from a drug allergy clinic in an Arabian Gulf Country, Kuwait

Penicillin allergy evaluation: Experience from Clinic of Allergology and Immunology, Clinical Center of Serbia

Positive penicillin allergy testing results: a systematic review and meta-analysis of papers published from 2010 through 2015

Contact Info

Product

Resources

About