Hypersensitivity to paracetamol: placebo effect or overdiagnosis?

Abstract

RATIONALE: Penicillin is reported as a drug allergy in 10% of the general population. We studied the epidemiology of documented penicillin allergy in patients entering the ED of an inner-city tertiary care hospital including the general prevalence, prevalence by race, and reports of multiple drug allergies, defined as 2 or more allergies. METHODS: This was a retrospective review of patients entering the ED of University Hospital from 01/2017-07/2017. We identified all patients with a documented penicillin allergy by a query of the electronic medical record, removing duplicate presentations for the same patient. The total number of patients presenting to the ED over the same time frame was identified. Excel sheet filters were used to tally the number of patients with penicillin allergy, the number of African Americans and Whites with penicillin allergy, and the number of patients with multiple drug allergies. RESULTS: Of 7291 patients presenting the ED from 01/2017 to 07/2017, 2503 (34%) had documented penicillin allergy. Penicillin allergy was documented in 45% (1390/3043) of African American patients. Similarly 46% (385/832) of White patients had documented penicillin allergy. Twenty-eight percent (701/2503) of patients with penicillin allergy also reported allergy to multiple drugs. CONCLUSIONS: The prevalence of documented penicillin allergy is greater in our inner-city tertiary care hospital than in the general population (34% versus 10%). Prevalence in the African American and White population is approximately equal, but greater than the general population. Patients with penicillin allergy are likely to report allergies to two or more drugs.