Resensitization in suspected penicillin allergy
-
Autor
Inmaculada Doña, Lucia Guidolin, Gádor Bogas, Elisa Olivieri, Marina Labella, Michele Schiappoli, Rocío Sáenz de Santa María, Annarita Dama, María Salas, Gianenrico Senna, Patrizia Bonadonna, María José Torres; Doña, Inmaculada; Guidolin, Lucia; Gádor Bogas, Elisa Olivieri; Marina Labella, Michele Schiappoli; [et al.] -
Fecha
2022-09-06 -
Editorial/Editor
Wiley -
Palabras clave
Anafilaxia -
Resumen
Background The diagnosis of allergic reactions to penicillins (AR-PEN) is very complex as there is a loss of sensitization over time, which leads to negative skin tests (STs) and specific IgE in serum, and even to tolerance to the drug involved. However, STs may become positive after subsequent exposure to the culprit drug (resensitization), with the risk of inducing potentially severe reactions. The exact rate of resensitization to penicillins is unknown, ranging from 0% to 27.9% in published studies. Objectives To analyze the rate of resensitization in patients with suggestive AR-PEN by repeating STs (retest) after an initial evaluation (IE). Material and Methods Patients with suspected AR-PEN were prospectively evaluated between 2017 and 2020. They underwent STs, and a randomized group also underwent a drug provocation test (DPT) with the culprit. Only patients with negative STs and/or DPT were included. All included cases were retested by STs at 2–8 weeks. Results A total of 545 patients were included: 296 reporting immediate reactions (IRs) and 249 non-immediate reactions (NIRs). Eighty (14.7%) cases had positive results in retest (RT+): 63 (21.3%) IRs and 17 (6.8%) NIRs (p < 0.0001). The rate of RT+ was higher in anaphylaxis compared with all other reactions (45.8% vs 9.1%, p < 0.0001). The risk of RT+ was higher from the fifth week after IE (OR: 4.64, CI: 2.1–11.6; p < 0.001) and increased with the patient's age (OR: 1.02; CI: 1.01–1.04; p = 0.009). Conclusions Due to the high rate of resensitization, retest should be included in the diagnostic algorithm of IRs to penicillins after an initial negative study, especially in anaphylaxis, to avoid potentially severe reactions after subsequent prescriptions of these drugs.
Colecciones
Estadísticas
Excepto si se señala otra cosa, la licencia del ítem se describe como Attribution-NonCommercial-NoDerivatives 4.0 Internacional
Ítems relacionados
Mostrando ítems relacionados por Título, autor o materia.
-
¿Qué queda de mí?
Calderon-Almendros, Ignacio; Gucciardi Heredia, Ángela Susana; Romero Paniagua, Carmen; Rosa Chacón, Alicia; Rosas Padilla, Lorena; [et al.] (2018-07-26)Este libro es una reclamación a quienes hemos sido, somos o seremos docentes. A quienes no hemos respetado a las personas que se han puesto junto a nosotros y nosotras, confiando su bien más preciado: la libertad. Estas ... -
Soy Niña
Calderon-Almendros, Ignacio; Arcos Repullo, Ana; Bravo Osorio, Noemí; Castillo Jimena, Sara; Jiménez de la Rubia, María; [et al.] (2018-07-25)Este libro pretende contribuir al reencuentro de la educación con esas finalidades que verdaderamente importan a una niña o un niño: ser feliz, jugar, vivir juntos y (no) aprender. Para ello hemos puesto el arte, nuestras ... -
The genomic history of the Iberian peninsula over the past 8000 years
Olalde, Iñigo; Swapan, Mallick; Patterson, Nick; Rohland, Nadin; Villalba-Mouco, Vanessa; [et al.] (2019)The lberian Península provides an excellent context in which to assess the final impact of population movements entering the European continent from the east as well as prehistoric and historie connections with North ...