Risk comparison of beta‐lactam‐induced anaphylaxis: Therapeutic stratification analysis in a Vietnamese pharmacovigilance database

Abstract

What is known and objective There is limited data on the specific risks of anaphylaxis induced by beta‐lactam drugs. The aim of this study was to compare the risks of reporting beta‐lactam‐induced anaphylaxis using the national pharmacovigilance database of Vietnam (NPDV). Methods The multivariate generalised linear regression model was applied for signal generation and comparison of beta‐lactams. Results Between 2010 and 2016, there were 2,921 reports of anaphylaxis (19.93%) from 14,655 spontaneous reports of beta‐lactam use in the NDPV. Anaphylaxis signal generation was also found for the subgroup J01D (cephalosporins and carbapenems) (ROR = 1.27 [1.16‐1.39]) and beta‐lactamase‐sensitive penicillins (ROR = 1.74 [1.27‐2.35]). In the third generation cephalosporin subgroup, different risks were identified for the following combinations of beta‐lactams: 1) cefotaxime with cefoperazone+sulbactam; 2) cefixime/cefpodoxime/cefdinir with cefoperazone+sulbactam or ceftizoxime/cefoperazone/ceftazidime/ceftriaxone/cefotaxime. For the second generation cephalosporin subgroup, different risks were found for cefotiam compared to cefmetazole, cefaclor, cefamandole and cefuroxime. What is new and conclusion These findings identified and highlighted the different anaphylactic risks caused by various beta‐lactams in the main subgroups.

Recent update on the management of anaphylaxis

“…6 Prevalence and major causative factors are listed in Table 1. [7][8][9][10][11][12][13] A systematic review using the estimates of time-trends in hospitalization and mortality showed the increasing prevalence of anaphylaxis in various countries, including Australia, Taiwan, the UK, and the US. 14 Foods were major causes in children, whereas drugs were major ones in adults, which tended to increase with age.…”