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门诊患者青霉素过敏标签去除后的长期随访。

Long-Term Follow-Up After Penicillin Allergy Delabeling in Ambulatory Patients.

机构信息

Allergy and Clinical Immunology Unit, Meir General Hospital, Kfar-Saba, Israel.

Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

J Allergy Clin Immunol Pract. 2019 Jan;7(1):231-235.e1. doi: 10.1016/j.jaip.2018.04.042. Epub 2018 May 22.

Abstract

BACKGROUND

Unverified penicillin allergy label has negative health implications. To address this, several delabeling methods have been proposed.

OBJECTIVES

To appraise the long-term outcomes of the penicillin allergy evaluation in ambulatory patients, focusing on subsequent use of penicillins in individuals found not allergic. A secondary objective was to examine the consistency between the evaluation's recommendations and the allergy label.

METHODS

A retrospective medical records review and phone survey were carried out in ambulatory patients who were evaluated for suspected penicillin allergy in our allergy unit. Patients with an uneventful oral challenge test (OCT) were interviewed regarding subsequent use of penicillins. Medical records were examined for antibiotic prescriptions and purchases. The records were also investigated for existing/erased penicillin allergy label and its consistency with the allergy evaluation.

RESULTS

Six hundred thirty-nine patients with an uneventful OCT were available for the survey. During a 56-month follow-up, 70% (447 patients) had used penicillins at least once. One hundred ninety-two patients (30%) did not use penicillins. The main reason for not using penicillins was lack of a clinical indication. Three hundred thirty-five patients (51.22%) carried a penicillin allergy label in their electronic medical file in spite of an uneventful OCT.

CONCLUSIONS

Penicillin allergy annulling via OCT has proven to be effective. Most of the patients who previously avoided penicillins have reused penicillins safely.

摘要

背景

未经证实的青霉素过敏标签会对健康产生负面影响。为了解决这个问题,已经提出了几种去标签方法。

目的

评估门诊患者青霉素过敏评估的长期结果,重点关注被评估为非过敏的个体随后使用青霉素的情况。次要目的是检查评估建议与过敏标签之间的一致性。

方法

对在我们的过敏科接受疑似青霉素过敏评估的门诊患者进行回顾性病历审查和电话调查。对口服挑战试验(OCT)无不良反应的患者进行后续青霉素使用情况的访谈。检查抗生素处方和购买情况。还调查了病历中现有的/已删除的青霉素过敏标签及其与过敏评估的一致性。

结果

共有 639 名 OCT 无不良反应的患者接受了调查。在 56 个月的随访期间,70%(447 名)至少使用过一次青霉素。192 名患者(30%)未使用青霉素。未使用青霉素的主要原因是缺乏临床指征。尽管 OCT 无不良反应,但仍有 335 名患者(51.22%)在电子病历中带有青霉素过敏标签。

结论

通过 OCT 消除青霉素过敏已被证明是有效的。大多数以前避免使用青霉素的患者已经安全地重新使用了青霉素。

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