Anaesthetic Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Department of Internal Medicine, Division of Allergy & Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Br J Anaesth. 2019 Jul;123(1):e82-e94. doi: 10.1016/j.bja.2019.01.026. Epub 2019 Mar 11.
Unsubstantiated penicillin-allergy labels are common in surgical patients, and can lead to significant harm through avoidance of best first-line prophylaxis of surgical site infections and increased infection with resistant bacterial strains. Up to 98% of penicillin-allergy labels are incorrect when tested. Because of the scarcity of trained allergists in all healthcare systems, only a minority of surgical patients have the opportunity to undergo testing and de-labelling before surgery. Testing pathways can be modified and shortened in selected patients. A variety of healthcare professionals can, with appropriate training and in collaboration with allergists, provide testing for selected patients. We review how patients might be assessed, the appropriate testing strategies that can be used, and the minimum standards of safe testing.
在外科患者中，未证实的青霉素过敏标签很常见，这可能会导致严重的后果，包括避免使用最佳的一线预防手术部位感染的药物，以及增加对耐药菌的感染。在经过测试后，高达 98%的青霉素过敏标签是不正确的。由于所有医疗保健系统中都缺乏经过培训的过敏专家，因此只有少数外科患者有机会在手术前进行测试和去除标签。可以在选定的患者中修改和缩短测试途径。各种医疗保健专业人员，在经过适当的培训并与过敏专家合作后，可以为选定的患者提供测试。我们回顾了如何评估患者、可以使用哪些适当的测试策略，以及安全测试的最低标准。
