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β-内酰胺类过敏的患病率:对以儿童为主的人群进行药物过敏评估的回顾性病历审查

Prevalence of beta-lactam allergy: a retrospective chart review of drug allergy assessment in a predominantly pediatric population.

作者信息

Abrams Elissa M, Wakeman Andrew, Gerstner Tom V, Warrington Richard J, Singer Alexander G

机构信息

Section of Allergy and Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.

University College Dublin, Dublin, Ireland.

出版信息

Allergy Asthma Clin Immunol. 2016 Nov 29;12:59. doi: 10.1186/s13223-016-0165-6. eCollection 2016.

Abstract

BACKGROUND

Research suggests that 90% of patients labeled beta-lactam allergic are able to tolerate penicillins following further assessment. This study aims to define and describe the frequency of true beta-lactam allergy following allergy patient evaluation in a predominantly pediatric population.

METHODS

306 primary care patients referred between January 2010 and June 2015 were assessed for a suspected beta-lactam allergy. Patient demographics, history and test results were extracted from electronic medical records. Testing performed was based on specialist recommendation following review of patient history.

RESULTS

34% of the study participants had intradermal testing. Oral challenge was given to 96.7% of the sample. 96% of patients with a prior history of beta-lactam allergy were advised that they could re-introduce beta-lactam antibiotics following evaluation.

CONCLUSIONS

Among patients with a documented beta-lactam allergy or a recent history of a reaction there is a low rate of 'true' beta-lactam allergy. Consistent evaluation of beta-lactam antibiotic allergies can reduce rates of broad spectrum antibiotic prescribing, among other harmful consequences.

摘要

背景

研究表明,在经过进一步评估后,90%被标记为对β-内酰胺类药物过敏的患者能够耐受青霉素。本研究旨在确定并描述在以儿童为主的人群中,经过过敏评估后真正β-内酰胺类药物过敏的发生率。

方法

对2010年1月至2015年6月间转诊的306例初级保健患者进行疑似β-内酰胺类药物过敏评估。从电子病历中提取患者的人口统计学信息、病史和检测结果。所进行的检测是根据对患者病史进行审查后专家的建议进行的。

结果

34%的研究参与者进行了皮内试验。96.7%的样本接受了口服激发试验。96%有β-内酰胺类药物过敏既往史的患者被告知,经过评估后他们可以重新使用β-内酰胺类抗生素。

结论

在有β-内酰胺类药物过敏记录或近期有反应病史的患者中,“真正”的β-内酰胺类药物过敏发生率较低。对β-内酰胺类抗生素过敏进行持续评估可以降低广谱抗生素的处方率以及其他有害后果。

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