Ali Syed, Hughes Tiffany, Smith Anthony
Department of Clinical Immunology and Allergy, Flinders Medical Centre, Bedford Park, Australia.
School of Medicine and Public Health, Flinders University, Bedford Park, Australia.
World Allergy Organ J. 2024 Jan 9;17(2):100863. doi: 10.1016/j.waojou.2023.100863. eCollection 2024 Feb.
Drug allergy clinic waitlist time data are limited. A 24-month retrospective study of drug allergy referrals was undertaken at a tertiary hospital in Australia. One hundred six patients were reviewed with a median age of 50 years (IQR 40.5-67.3) and a female predominance (n = 76, 71%). Face-to-face consultations were common (n = 83, 78.3%) with the remainder being telephone consultations. General practitioners comprised just over one-third (n = 38, 35.9%) of the referrers but majority being from within the hospital, such as the emergency department (n = 22, 20.8%). Most patients (n = 100, 94.3%) were triaged as Category 1 or urgent. Antibiotic allergies were common (n = 75, 70.8%), of which majority were beta-lactam antibiotics (n = 71, 95%): 55 (73.3%) for penicillins and 16 (15.1%) for cephalosporins. The median waitlist time was 178 days (IQR 48.5-502.5) and only 18 (17%) of Category 1 were seen within urgent timeframe. Telephone consultation had a significantly shorter waitlist time (median 47 days; IQR 6-245) compared to face-to-face consultations (median 267 days; IQR 69-519) (p = 0.026). Large waitlist times are present for drug allergy, and given the majority of referrers are from hospitals, inpatient drug allergy assessment remains paramount. Beta-lactam antibiotic drug allergy labels remain common, and given their negative implications, further work is needed. Economic and human resources evaluations are required to address this shortfall.
药物过敏门诊候诊时间的数据有限。在澳大利亚一家三级医院对药物过敏转诊患者进行了一项为期24个月的回顾性研究。共审查了106例患者,中位年龄为50岁(四分位间距40.5 - 67.3),女性居多(n = 76,71%)。面对面咨询很常见(n = 83,78.3%),其余为电话咨询。转诊医生中全科医生略超过三分之一(n = 38,35.9%),但大多数来自医院内部,如急诊科(n = 22,20.8%)。大多数患者(n = 100,94.3%)被分诊为1类或紧急情况。抗生素过敏很常见(n = 75,70.8%),其中大多数是β-内酰胺类抗生素(n = 71,95%):青霉素过敏55例(73.3%),头孢菌素过敏16例(15.1%)。中位候诊时间为178天(四分位间距48.5 - 502.5),只有18例(17%)1类患者在紧急时间范围内得到诊治。与面对面咨询(中位267天;四分位间距69 - 519)相比,电话咨询的候诊时间明显更短(中位47天;四分位间距6 - 245)(p = 0.026)。药物过敏存在较长的候诊时间,鉴于大多数转诊医生来自医院,住院药物过敏评估仍然至关重要。β-内酰胺类抗生素药物过敏标签仍然很常见,鉴于其负面影响,需要进一步开展工作。需要进行经济和人力资源评估以弥补这一不足。