Allergy Unit, Regional University Hospital of Malaga-IBIMA-UMA, Malaga, Spain.
Department of Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey.
Allergy. 2019 Jun;74(6):1052-1062. doi: 10.1111/all.13721. Epub 2019 Feb 17.
An accurate diagnosis of β-lactam (BL) allergy can reduce patient morbidity and mortality. Our aim was to investigate the availability of BL reagents, their use and test procedures in different parts of Europe, as well as any differences in the diagnostic workups for evaluating subjects with BL hypersensitivity. A survey was emailed to all members of the EAACI Drug Allergy Interest Group (DAIG) between February and April 2016, and the questionnaire was meant to study the management of suspected BL hypersensitivity. The questionnaire was emailed to 82 DAIG centres and answered by 57. Amoxicillin alone or combined to clavulanic acid were the most commonly involved BL except in the Danish centre, where penicillin V was the most frequently suspected BL. All centres performed an allergy workup in subjects with histories of hypersensitivity to BL: 53 centres (93%) followed DAIG guidelines, two national guidelines and two local guidelines. However, there were deviations from DAIG recommendations concerning allergy tests, especially drug provocation tests. A significant heterogeneity exists in current practice not only among countries, but also among centres within the same country. This suggests the need to re-evaluate, update and standardize protocols on the management of patients with suspected BL allergy.
准确诊断β-内酰胺(BL)过敏可以降低患者的发病率和死亡率。我们的目的是调查欧洲不同地区 BL 试剂的可用性、使用情况和检测程序,以及评估 BL 超敏反应患者的诊断工作流程是否存在差异。2016 年 2 月至 4 月期间,我们向 EAACI 药物过敏兴趣小组(DAIG)的所有成员发送了电子邮件调查,并设计了问卷调查表来研究 BL 疑似过敏的管理情况。该问卷发送到了 82 个 DAIG 中心,其中 57 个中心进行了回复。除了丹麦中心,其中最常怀疑的 BL 是青霉素 V,阿莫西林单独或与克拉维酸联合使用是最常涉及 BL。所有中心均对有 BL 过敏史的患者进行过敏检测:53 个中心(93%)遵循 DAIG 指南、2 个国家指南和 2 个地方指南。然而,在过敏测试方面,与 DAIG 建议存在偏差,尤其是药物激发试验。目前的实践存在显著的异质性,不仅存在于国家之间,也存在于同一国家的不同中心之间。这表明需要重新评估、更新和标准化 BL 疑似过敏患者管理的方案。