Prevalence of self‐reported and confirmed penicillin allergy in a Belgian outpatient population

Gasse, Athina L. Van; Oulkadi, Redouane; Mousati, Zakaria; Ebo, Didier G.; Chiriac, Anca Mirela; Poorten, Marie-Line M. van der; Hagendorens, Margo M.; Faber, Margaretha A.; Elst, Jessy; Mertens, Christel; Puysseleyr, Leander De; Coenen, Samuel; Sabato, Vito

doi:10.1111/all.14292

Cited by 14 publications

(8 citation statements)

References 9 publications

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“…In 2017, 6.1% of patients reported an antibiotic allergy (of which 90% penicillin) at Ghent University Hospital surgical day hospitalization [ 32 ]. However, based on a prospective observational study in a Belgian outpatient population, 91% of the participants could be safely delabeled [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

In-hospital antibiotic use for severe chronic obstructive pulmonary disease exacerbations: a retrospective observational study

et al. 2023

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Background The use of antibiotics in mild to severe acute exacerbations of chronic obstructive pulmonary disease (COPD) remains controversial. Aim To explore in-hospital antibiotic use in severe acute exacerbations of COPD (AECOPD), to analyze determinants of in-hospital antibiotic use, and to investigate its association with hospital length of stay (LOS) and in-hospital mortality. Methods A retrospective, observational study was conducted in Ghent University Hospital. Severe AECOPD were defined as hospitalizations for AECOPD (ICD-10 J44.0 and J44.1) discharged between 2016 and 2021. Patients with a concomitant diagnosis of pneumonia or ‘pure’ asthma were excluded. An alluvial plot was used to describe antibiotic treatment patterns. Logistic regression analyses identified determinants of in-hospital antibiotic use. Cox proportional hazards regression analyses were used to compare time to discharge alive and time to in-hospital death between antibiotic-treated and non-antibiotic-treated AECOPD patients. Results In total, 431 AECOPD patients (mean age 70 years, 63% males) were included. More than two-thirds (68%) of patients were treated with antibiotics, mainly amoxicillin-clavulanic acid. In multivariable analysis, several patient-related variables (age, body mass index (BMI), cancer), treatment-related variables (maintenance azithromycin, theophylline), clinical variables (sputum volume and body temperature) and laboratory results (C-reactive protein (CRP) levels) were associated with in-hospital antibiotic use independent of sputum purulence, neutrophil counts, inhaled corticosteroids and intensive care unit of which CRP level was the strongest determinant. The median hospital LOS was significantly longer in antibiotic-treated patients (6 days [4–10]) compared to non-antibiotic-treated patients (4 days [2–7]) (p < 0.001, Log rank test). This was indicated by a reduced probability of hospital discharge even after adjustment for age, sputum purulence, BMI, in-hospital systemic corticosteroid use and forced expiratory volume in one second (FEV1) (adjusted hazard ratio 0.60; 95% CI 0.43; 0.84). In-hospital antibiotic use was not significantly associated with in-hospital mortality. Conclusions In this observational study in a Belgian tertiary hospital, in-hospital antibiotic use among patients with severe AECOPD was determined by the symptom severity of the exacerbation and the underlying COPD severity as recommended by the guidelines, but also by patient-related variables. Moreover, in-hospital antibiotic use was associated with a longer hospital stay, which may be linked to their disease severity, slower response to treatment or 'harm' due to antibiotics. Trial registration Number: B670201939030; date of registration: March 5, 2019.

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Section: Discussionmentioning

confidence: 99%

In-hospital antibiotic use for severe chronic obstructive pulmonary disease exacerbations: a retrospective observational study

et al. 2023

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“…In a recent prospective study performed in Antwerp, Belgium, prevalence of self-reported penicillin allergy was 12%. However, it considered a population visiting the outpatients' allergy departments presumably inducing referral bias (28).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Antibiotic Allergy Labels in a Tertiary Referral Center in Belgium

Gilissen

Spriet

Gilis

et al. 2021

The Journal of Allergy and Clinical Immunology: In Practice

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“…In fact, only approximately 5% of the patients will finally be diagnosed with an IDHRs to AXE. 9 A new diagnostic test should therefore be able to offer absolute specificity to reduce the pandemic of false 'penicillin allergy'. Admittedly, accuracy is still not absolute and there is still far to go from this proof of concept to mainstream use.…”

Section: Dual Intracellular Staining Of Cd154 (Cd40l) and Cytokines A...mentioning

confidence: 99%

“…The maximal net AXE‐induced intracellular expression of CD154, IL‐4, and IFN‐γ is 0.03%, 0.25% and 0.10% respectively. Therefore, keeping in mind the low pretest probability related to the pandemic of false ‘penicillin allergy’, 9 we deemed it necessary to avoid false positive results. Hence, we fixed the decision thresholds at the upper values measured in the control individuals, keeping false positive results at 0%.…”

Section: Figurementioning

confidence: 99%

Dual intracellular staining of CD154 (CD40L) and cytokines at single‐cell level: A novel aid to document immediate hypersensitivity to amoxicillin

Ebo

Elst

Mertens

et al. 2023

Clin Experimental Allergy

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Prevalence of self‐reported and confirmed penicillin allergy in a Belgian outpatient population

Abstract: Cilostazol inhibits cytokine-induced nuclear factor-kappaB activation via AMP-activated protein kinase activation in vascular endothelial cells.

Cited by 14 publications

References 9 publications

In-hospital antibiotic use for severe chronic obstructive pulmonary disease exacerbations: a retrospective observational study

In-hospital antibiotic use for severe chronic obstructive pulmonary disease exacerbations: a retrospective observational study

Prevalence of Antibiotic Allergy Labels in a Tertiary Referral Center in Belgium

Dual intracellular staining of CD154 (CD40L) and cytokines at single‐cell level: A novel aid to document immediate hypersensitivity to amoxicillin

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