Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium; Department of Dermatology, Contact Allergy Unit, University Hospitals Leuven, Leuven, Belgium.
Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium; Pharmacy Department, University Hospitals Leuven, Leuven, Belgium.
J Allergy Clin Immunol Pract. 2021 Jun;9(6):2415-2425.e8. doi: 10.1016/j.jaip.2021.01.047. Epub 2021 Feb 16.
Antibiotic (AB) allergies are among the most frequently occurring adverse drug reactions. In US literature, AB allergy labels (AAL) are reported in 10% to 15% of patients' charts; however, large-scale European analyses are scarce.
To retrospectively assess the prevalence of AAL in a tertiary referral hospital in Belgium between 2010 and 2018.
Patients who consulted and/or were hospitalized during the study period, who had been labeled with an AB allergy, were selected for further analysis.
Of 1,009,598 unique patients (outpatients, n = 736,469; inpatients, n = 273,129), 28,147 patients (3%) were registered with 1 or more AAL, being 1% of outpatients (n = 9562) and 7% of inpatients (n = 18,585). Women were more likely to carry an AAL (68%) compared with men (32%, P < .001). In patients with an AAL, 9% had multiple labels and 5% had labels for multiple AB classes. Most frequently, beta-lactams were involved (84% of AAL), followed by quinolones (7%) and sulfonamides and macrolides (both 3%). Moreover, 88% of the reactions were self-reported, mostly being an unspecified rash (53%), whereas only 3% were considered confirmed AAL.
With an overall prevalence of 3%, the burden of AAL is less in our Western European center compared with US reports. However, this prevalence most likely still represents an overestimation of genuine AB allergic patients because most labels lack confirmation and/or specifications. Our work indicates that knowledge of the local epidemiology of AAL is necessary to estimate the impact of better allergy labeling and delabeling strategies.
抗生素（AB）过敏是最常见的药物不良反应之一。在美国文献中，10%至 15%的患者病历中报告了 AB 过敏标签（AAL）；然而，大规模的欧洲分析却很少见。
回顾性评估 2010 年至 2018 年期间比利时一家三级转诊医院的 AAL 患病率。
选择在研究期间就诊和/或住院的、被标记为 AB 过敏的患者进行进一步分析。
在 1009598 名（门诊患者，n=736469；住院患者，n=273129）唯一患者中，有 28147 名患者（3%）被标记为 1 个或多个 AAL，占门诊患者的 1%（n=9562）和住院患者的 7%（n=18585）。与男性（32%，P<.001）相比，女性更有可能携带 AAL（68%）。在携带 AAL 的患者中，9%有多个标签，5%有多个 AB 类别的标签。最常见的是涉及β-内酰胺类（84%的 AAL），其次是喹诺酮类（7%）和磺胺类及大环内酯类（均为 3%）。此外，88%的反应是自我报告的，主要是未指明的皮疹（53%），而只有 3%被认为是确认的 AAL。
在我们的西欧中心，AAL 的总体患病率为 3%，与美国的报告相比，其负担较轻。然而，由于大多数标签缺乏确认和/或说明，这种患病率很可能仍然高估了真正的 AB 过敏患者。我们的工作表明，了解 AAL 的当地流行病学情况对于评估更好的过敏标签和去标签策略的影响是必要的。
