Frequency of self-reported drug allergy

Sousa‐Pinto, Bernardo; Fonseca, João; Gomes, Eva

doi:10.1016/j.anai.2017.07.009

Cited by 98 publications

(42 citation statements)

References 50 publications

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“…In 1 systemic review paper, drug allergy rates were higher among adults mainly for antibiotics, nonsteroidal ant-inflammatory drugs, and anesthetics. [ 28 ] Their results support the current study findings in which adults were 1.25 times more likely to suffer from drug allergies rather than food allergies. It is noteworthy that the rate of biphasic/protracted anaphylaxis in this setting was 6.2%, which was comparable to the findings in the literature that ranged from 10% to 23%.…”

Section: Discussionsupporting

confidence: 89%

Prevalence triggers and clinical severity associated with anaphylaxis at a tertiary care facility in Saudi Arabia

et al. 2018

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Anaphylaxis is a systemic and hypersensitive allergic reaction caused by various triggers such as environmental, food, drug, and insects. The aim of this study was to identify the prevalence, triggers, and clinical severity of anaphylaxis in 2 emergency departments (EDs) in Saudi Arabia.A cross-sectional study based on a screening of medical records was conducted between January 2015 and August 2017, to identify confirmed cases of anaphylaxis. Patient characteristics were age, sex, previously known allergies, and the triggering allergens. The clinical severity was measured on the basis of the anaphylaxis international assessment tool (mild, moderate, severe). Factors associated with triggers and severities were identified.The period prevalence of anaphylaxis among ED admissions was 0.00026%. Pediatric cases (age 1–16 years) were 98 (60.9%), while adults (age 17–40 years) were 63 (39.1%). Triggers of anaphylaxis were food 63 (39.1%), insects 62 (38.5%), drugs 28 (17.4%), and environmental 8 (5.0%). Mild symptoms were observed in 41 (25%) of the sample, while moderate and severe symptoms were observed in 116 (72%) and 4 (3%) of the cases, respectively. Adults were 1.25 times more likely to endure drug allergy rather than food allergy, than pediatrics with adj.P = .015. ED admissions in summer season were 1.29 less likely to be due to drug allergy rather than insect allergy, compared with admissions in winter season, adj.P = .01. Cases with known allergy were 1.72 times less likely to endure drug allergy rather than food allergy, compared with those with unknown allergy, adj.P = .001. Adults were 4.79 more likely to endure severe symptoms than pediatrics with adj.P = .001.Although the prevalence of anaphylaxis was higher in pediatrics, yet the disease was more severe in adults. Special consideration should be paid to anaphylaxis triggered by insect bites in summer, and food allergy among cases with unknown allergy upon ED admission.

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Section: Discussionsupporting

confidence: 89%

Prevalence triggers and clinical severity associated with anaphylaxis at a tertiary care facility in Saudi Arabia

et al. 2018

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“…The results may, therefore, reflect the degree to which individuals were bothered by these symptoms rather than actual occurrence of the symptoms themselves. Moreover, men may report adverse reactions less frequently than women, 45 and as such this reporting could bias the results if men (but not women) underreported adverse reactions. Active, real-time follow-up of persons prescribed these medications may be needed to disentangle symptom occurrence from other factors influencing individuals' willingness to report a symptom to healthcare providers (eg, the degree to which individuals are bothered by symptoms).…”

Section: Discussionmentioning

confidence: 99%

Sex differences in type and occurrence of adverse reactions to opioid analgesics: a retrospective cohort study

et al. 2021

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ObjectivesSex as a biological variable affects response to opioids. However, few reports describe the prevalence of specific adverse reactions to commonly prescribed opioids in men and women separately. A large cohort was used to investigate sex differences in type and occurrence of adverse reactions associated with use of codeine, tramadol, oxycodone and hydrocodone.DesignRetrospective cohort study.SettingParticipants in the Right Drug, Right Dose, Right Time (RIGHT) Study.ParticipantsThe medical records of 8457 participants in the RIGHT Study who received an opioid prescription between 1 January 2004 and 31 December 2017 were reviewed 61% women, 94% white, median age (Q1–Q3)=58 (47–66).Primary and secondary outcome measuresAdverse reactions including gastrointestinal, skin, psychiatric and nervous system issues were collected from the allergy section of each patient’s medical record. Sex differences in the risk of adverse reactions due to prescribed opioids were modelled using logistic regression adjusted for age, body mass index, race and ethnicity.ResultsFrom 8457 participants (of which 449 (5.3%) reported adverse reactions), more women (6.5%) than men (3.4%) reported adverse reactions to at least one opioid (OR (95% CI)=2.3 (1.8 to 2.8), p<0.001). Women were more likely to report adverse reactions to tramadol (OR (95% CI)=2.8 (1.8 to 4.4), p<0.001) and oxycodone (OR (95% CI)=2.2 (1.7 to 2.9), p<0.001). Women were more likely to report gastrointestinal (OR (95% CI)=3.1 (2.3 to 4.3), p<0.001), skin (OR (95% CI)=2.1 (1.4 to 3.3), p=0.001) and nervous system issues (OR (95% CI)=2.3 (1.3 to 4.2), p=0.004).ConclusionsThese findings support the importance of sex as a biological variable to be factored into pain management studies.

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“…[17,18] Drug HSRs comprise up to 20% of ADRs and are reported in approximately 8% of general populations. [19,20] Cutaneous reactions, including rash and hives, are the most commonly reported HSRs. [21,22] Although most patients are labelled with an antibiotic allergy at the time of hospital admission, new onset cutaneous HSRs were found to affect approximately 2% of inpatients.…”

Section: Epidemiologymentioning

confidence: 99%

“…The frequency of documented drug allergy is higher in women, those of self-reported European ancestry, adults, and in inpatients. [20,24] Female predominance has been stable across multiple studies for reported allergies, especially for antibiotic allergies, but no sex effect has been demonstrated in children. [24,25,45] Patients whose self-determined ancestry is European report more IgE-mediated HSRs.…”

Section: Epidemiologymentioning

confidence: 99%

Antibiotic allergy

et al. 2019

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Antibiotics are the commonest cause of life-threatening immune-mediated drug reactions that are considered off-target, including anaphylaxis, and organ-specific and severe cutaneous adverse reactions. However, many antibiotic reactions documented as allergies were unknown or not remembered by the patient, cutaneous reactions unrelated to drug hypersensitivity, drug-infection interactions, or drug intolerances. Although such reactions pose negligible risk to patients, they currently represent a global threat to public health. Antibiotic allergy labels result in displacement of first-line therapies for antibiotic prophylaxis and treatment. A penicillin allergy label, in particular, is associated with increased use of broad-spectrum and non-β-lactam antibiotics, which results in increased adverse events and antibiotic resistance. Most patients labelled as allergic to penicillins are not allergic when appropriately stratified for risk, tested, and re-challenged. Given the public health importance of penicillin allergy, this Review provides a global update on antibiotic allergy epidemiology, classification, mechanisms, and management.

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Frequency of self-reported drug allergy

Cited by 98 publications

References 50 publications

Prevalence triggers and clinical severity associated with anaphylaxis at a tertiary care facility in Saudi Arabia

Prevalence triggers and clinical severity associated with anaphylaxis at a tertiary care facility in Saudi Arabia

Sex differences in type and occurrence of adverse reactions to opioid analgesics: a retrospective cohort study

Antibiotic allergy

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