Drug allergy in a general hospital: results of a novel prospective inpatient reporting system

Thong, Bernard Yu‐Hor; Leong, Keng Hong; Tang, Camelia Qian Ying; Chng, H H

doi:10.1016/s1081-1206(10)61804-2

Cited by 101 publications

(64 citation statements)

References 10 publications

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“…We had an increased number of consultation for female patients, which is similar to other studies (2)(3)(4)(5). One patient presented anaphylaxis immediately after carbamazepine intake, but skin testing other than patch is not standardized, and a confirmatory diagnostic work-up was not performed due to the availability of alternative medication.…”

Section: Resultssupporting

confidence: 74%

“…There are few studies regarding inpatient consultations for allergy and immunology (1)(2)(3), and data are scarce when limited to inpatient drug allergy consultations. Adverse drug reactions (ADRs) have been reported in up to 10-20% of patients, with up to one-third of these reactions being allergic or pseudo-allergic in nature (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

“…Adverse drug reactions (ADRs) have been reported in up to 10-20% of patients, with up to one-third of these reactions being allergic or pseudo-allergic in nature (3)(4)(5). Previous studies reported an incidence of drug allergic reactions among inpatients from 0.42% to 0.87% (3)(4)(5), with referral rates from 0.078% to 0.231% (3,4), but there are no data regarding Gulf-area countries, such as Kuwait. As the problem of drug allergies is growing worldwide, we sought to investigate referrals for drug allergies to clarify the pattern of inpatient consultations at our drug allergy unit in AlRashed Allergy Center in terms of incidence, related drugs and allergy evaluation outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Pattern of inpatient referrals to a drug allergy unit in Kuwait

Al‐Ahmad

Bouza

2017

Eur Ann Allergy Clin Immunol

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Section: Resultssupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pattern of inpatient referrals to a drug allergy unit in Kuwait

Al‐Ahmad

Bouza

2017

Eur Ann Allergy Clin Immunol

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“…(1) In a local study on hospitalised patients with drug allergies, allopurinol was the culprit drug in 5.7% of patients and accounted for 38% of cases of DRESS; it was one of the top three causative drugs in SCAR. (19) Patient deaths due to allopurinol allergy have been featured in local newspapers over the past decade and resulted in two 'Dear Healthcare Professional Letters' issued by the Health Sciences Authority, Singapore, which may have increased the fear of using allopurinol. (20,21) The maximum dose of allopurinol is 800 mg daily; however, it is often administered in a fixed dose of 300 mg.…”

Section: Physician Factorsmentioning

confidence: 99%

Poorly controlled gout: who is doing poorly?

Chia¹

2016

smedj

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Gout, an inflammatory arthritis caused by the deposition of monosodium urate crystals, is commonly seen in primary care and specialist clinics. In recent years, there has been a resurgence of interest in gout due to advances in therapies and the understanding of pathophysiology, with new guidelines being published by international bodies. However, there is still a gap between the goals of treatment and actual day-to-day practice. Barriers that result in poorly controlled gout include patient factors such as lack of understanding of the disease, stigma and nonadherence to treatment, as well as physician factors such as knowledge gaps, inadequate use of allopurinol and lack of ownership of the disease. The medical profession needs to do more to bridge the gap through physician and patient education, identification of treatment targets with appropriate use of drugs, and dissemination of guidelines.

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“…[13][14][15] Although anaphylactic reaction to penicillin is a rare event, this drug is still accountable for around 75% of fatal cases of anaphylaxis in the United States every year. 16 Thong et al, 2 in a prospective study conducted between 1997 and 1999, in a general hospital of Singapore, assessed approximately 90,910 admissions, of which 366 were due to adverse reactions, and of these 72 were AR (19%). Antimicrobials, especially beta-lactams, specifically penicillins, and antiepileptic drugs accounted for 7% of allergic reactions.…”

mentioning

confidence: 99%

Reações alérgicas a medicamentos

Nagão-Dias¹,

Barros-Nunes²,

Coêlho³

et al. 2004

J. Pediatr. (Rio J.)

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Objective: This review addresses the most recent published literature regarding drug allergy, in order to provide physicians with a background for a better understanding of this problem of great relevance for public health. Sources of data:The sources of data for obtaining the original and review articles published in the last 10 years were MEDLINE, Pubmed and Lilacs. The articles chosen for this review relate drug allergy to immunological mechanisms, epidemiology, clinical and laboratory evaluation, skin lesions, clinical management, and re-exposure to the drug.Summary of the findings: Allergic reactions represent one third of adverse drug reactions. They are considered rare but with high morbimortality. Gell & Coombs definition has been useful for classifying some types of drug allergic reactions; however, some still remain without classification because of poor knowledge of the mechanisms involved. The existence of T cell subpopulations with diverse characteristics reveals the complexity of the subject and, at the same time, elucidates several questions raised about it. It was recently postulated a new concept of chemically inert drug presentation to T cells, restricted to the major histocompatibility complex, but in a non-covalent and labile way. In clinical practice, without adequate laboratory tests, it is difficult to correlate clinical symptoms and immunological mechanisms. In vitro and in vivo skin tests have been employed in cases of suspected drug allergy reaction. However, there are very few commercially available reagents.Conclusions: Drug allergy constitutes an important problem in adverse drug reactions because of its potential of morbidity and mortality. It is necessary to emphasize the relevance of pharmacovigilance during treatment of patients, as well as the identification of possible immunological mechanisms involved in the events, through laboratory tests and detailed history and clinical evaluation.

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Drug allergy in a general hospital: results of a novel prospective inpatient reporting system

Cited by 101 publications

References 10 publications

Pattern of inpatient referrals to a drug allergy unit in Kuwait

Pattern of inpatient referrals to a drug allergy unit in Kuwait

Poorly controlled gout: who is doing poorly?

Reações alérgicas a medicamentos

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