Copaescu Ana M, Mak Hugo W F, Vogrin Sara, Holmes Natasha E, Trubiano Jason A, Li Philip H
Department of Infectious Diseases, Centre for Antibiotic Allergy and Research, Austin Health, Heidelberg, Australia.
Division of Allergy and Clinical Immunology, Department of Medicine, and The Research Institute of the McGill University Health Centre, McGill University Health Centre (MUHC), McGill University, Montreal, Quebec, Canada.
J Allergy Clin Immunol Glob. 2024 Oct 18;4(1):100354. doi: 10.1016/j.jacig.2024.100354. eCollection 2025 Feb.
Penicillin allergy labels are associated with many adverse outcomes. Fear and restriction of future medication use also have an impact on health-related quality of life (HR-QoL). However, the impact of a drug allergy on HR-QoL and its associated factors remains unknown.
We sought to investigate the impact of penicillin allergy labels and compare the factors associated with HR-QoL impairment among patients in an international multicenter, multiethnic cohort.
HR-QoL was measured using the 6-item Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) and compared among patients labeled with penicillin allergy, before their allergy evaluation, from 8 adult allergy/immunology clinics across Asia, Australia, and North America.
We recruited 643 patients labeled with penicillin allergy (median age, 56 years [interquartile range, 39-67]; male:female ratio, 1:2.2), with 273 (42.5%), 186 (28.9%), and 184 (28.6%) from Asia, North America, and Australia, respectively. The median DrHy-Q score was 8.3 (interquartile range, 0.0-29.2). All patients underwent penicillin allergy evaluation, and 96% (617 of 643) were delabeled following negative provocation test results. Female patients (8.3 vs 4.2; = .003), those with other concomitant antimicrobial allergy labels (20.8 vs 4.2; = .004), and patients from Asia (33.3 vs 4.2 [North America] vs 0 [Australia]; < .001) had significantly higher DrHy-Q scores, reflecting a reduced HR-QoL. Ethnicity as well as other allergy variables were not significant in the multivariate analysis.
Regional differences, ethnicity, and other risk factors influence HR-QoL impairment among patients labeled with penicillin allergy. Future studies are needed to understand the contributions of regional sociodemographic factors and identify interventions to improve HR-QoL.
青霉素过敏标签与许多不良后果相关。对未来用药的恐惧和限制也会对健康相关生活质量（HR-QoL）产生影响。然而，药物过敏对HR-QoL的影响及其相关因素仍不清楚。
我们试图调查青霉素过敏标签的影响，并比较国际多中心、多种族队列中患者HR-QoL受损的相关因素。
使用6项药物超敏生活质量问卷（DrHy-Q）测量HR-QoL，并在来自亚洲、澳大利亚和北美的8家成人过敏/免疫诊所中，对青霉素过敏标签患者在过敏评估前进行比较。
我们招募了643名青霉素过敏标签患者（中位年龄56岁[四分位间距，39-67]；男女比例为1:2.2），分别来自亚洲、北美和澳大利亚的有273名（42.5%）、186名（28.9%）和184名（28.6%）。DrHy-Q中位得分为8.3（四分位间距，0.0-29.2）。所有患者均接受了青霉素过敏评估，96%（643例中的617例）在激发试验结果为阴性后被去除标签。女性患者（8.3对4.2；P = 0.003）、有其他抗菌药物过敏标签的患者（20.8对4.2；P = 0.004）以及来自亚洲的患者（33.3对4.2[北美]对0[澳大利亚]；P < 0.001）的DrHy-Q得分显著更高，反映出HR-QoL降低。在多变量分析中，种族以及其他过敏变量不显著。
地区差异、种族和其他风险因素会影响青霉素过敏标签患者的HR-QoL受损情况。需要进一步研究以了解地区社会人口学因素的作用，并确定改善HR-QoL的干预措施。
