A retrospective study on the true prevalence of allergy to beta-lactam antibiotics in an adult population in Switzerland

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ID Serval
serval:BIB_168ED0F12DAD
Type
Mémoire
Sous-type
(Mémoire de) maîtrise (master)
Collection
Publications
Institution
Titre
A retrospective study on the true prevalence of allergy to beta-lactam antibiotics in an adult population in Switzerland
Auteur⸱e⸱s
IULIANO S.
Directeur⸱rice⸱s
COMTE D.
Détails de l'institution
Université de Lausanne, Faculté de biologie et médecine
Statut éditorial
Acceptée
Date de publication
2020
Langue
anglais
Nombre de pages
34
Résumé
Background: Studies suggest that 90% of patients labelled as allergic to penicillin tolerate it
after rigorous assessment. Here, we examined the true frequency of allergies to beta-lactam
antibiotics subclasses, as well as the negative predictive value (NPV) of skin testing in an adult
population referred to a university allergy clinic in Switzerland.
Methods: This is a retrospective study in which we examined the clinical records of patients
who were investigated for a label of allergy to beta-lactam (penicillin, cephalosporin or
carbapenem) antibiotics between January 1st 2011 and December 31st 2018.
Results: 582 patients were identified with a documented allergy to beta-lactam antibiotics
and 477 patients were systemically investigated by skin tests and/or drug challenge to confirm
or rule out allergy. 262 patients reported a history of immediate reactions, 137 of delayed
reactions, and 114 of unknown reactions. Overall, 88 (15.1%) patients were truly allergic to
any beta-lactam antibiotics; 64 (11.0%) with an immediate reaction and 24 (4.1%) with a
delayed reaction. Most frequently identified true allergy was penicillin (65 patients), followed
by cephalosporin (21 patients) and carbapenem (2 patients). NPV of skin tests for all beta-
lactam were 97.7% and 92.5% for immediate and delayed reactions, respectively, and 96.3%
and 92.1% when penicillin was considered. Systemic allergic reaction occurred in 0.6% of skin
tests and in 3.1% of drug challenges.
Conclusions: Only 15.1% of patients with beta-lactam allergy label are truly allergic and non-
allergic patients can be safely identified and delabelled by a rigorous allergic work-up based
on skin tests and drug challenge.
Mots-clé
allergy, beta-lactam, penicillin, prevalence, negative predictive value of skin tests
Création de la notice
07/09/2021 14:10
Dernière modification de la notice
06/10/2022 6:39
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