Evaluation of Antibiotic Allergy in the Ambulatory Setting Using a Standardized Questionnaire.

Autor:	Yi SM; Stritch School of Medicine, Maywood, IL, USA., Barsanti-Sekhar M; Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA., Wozniak AW; Clinical Research Office, Center for Translational Research and Education, Maywood, IL, USA., Santarossa M; Divison of Infectious Diseases, Loyola University Medical Center, Maywood, IL, USA., Adams J; Department of Pharmacy, Loyola University Medical Center, Maywood, IL, USA., Albarillo F; Division of Infectious Diseases, Loyola University Medical Center, Maywood, IL, USA.
Jazyk:	angličtina
Zdroj:	Journal of pharmacy practice [J Pharm Pract] 2024 Oct; Vol. 37 (5), pp. 1121-1126. Date of Electronic Publication: 2024 Jan 18.
DOI:	10.1177/08971900241227977
Abstrakt:	Patients are sometimes mislabeled as having an immune-mediated antibiotic allergy in their medical records. Therefore, the aim of this study was to investigate the prevalence of subjects with non-immune mediated reactions to antibiotics using a standardized questionnaire. Subjects aged 18 years and older with a documented antibiotic allergy were identified and recruited from 2 outpatient clinics in the greater Chicago area. Subjects completed a standardized questionnaire during a single visit regarding their previous adverse reaction to an antibiotic. For subjects with multiple documented antibiotic allergies, 1 questionnaire was filled out for each antibiotic allergy. Investigators subsequently evaluated the questionnaire responses to determine whether the adverse reaction was a true immune-mediated allergic reaction or an adverse drug reaction. A total of 98 subjects were recruited with completion of 159 questionnaires. Eighteen subjects (18.37%, 95% CI: 10.7%, 26.3%) had antibiotic allergy labels with no corresponding immune-mediated reaction history. There were 35 allergy labels (22.0%, 95% CI: 14.7%, 29.4%) that were unlikely to be immune-mediated. Antibiotics with the highest percentage of clinical histories that were unlikely to be immune-mediated were macrolides (8 of 11 subjects), nitrofurantoin (1 of 2 subjects), and amoxicillin/clavulanate (2 of 8 subjects). The most common antibiotic allergy labels were penicillin (43 of 159 subjects), sulfonamides (25 of 159 subjects), and fluoroquinolones (21 of 159 subjects). Identification of adverse reactions to antibiotics that are unlikely to be immune-mediated can be accomplished using a standardized questionnaire in the outpatient setting. Improved identification of low-risk antibiotic allergy labels can guide de-labeling initiatives to improve antibiotic prescribing. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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