Characteristics of nonsteroidal anti-inflammatory drugs hypersensitivity at Songklanagarind Hospital

Abstract

RATIONALE: About 10% of patients report allergy to penicillin. Of those patients evaluated with a penicillin skin test (ST) and challenge, 90-99% are able to tolerate penicillin, resulting in penicillin allergy de-labeling. However, while patients are often de-labeled in the short term, factors that predict the persistence of penicillin allergy de-labeling remain unknown. METHODS: A retrospective chart review was conducted on patients evaluated for penicillin allergy from 2012-2017(inpatient and outpatient). Data was collected from the electronic medical record (EMR), pharmacy records, as well as a follow-up telephone survey with patients. RESULTS: Thirty-three patients were successfully de-labeled of their penicillin allergy (negative ST and tolerated oral challenge). One-third of these patients had persistence of their penicillin allergy in the EMR (11/ 33), and 7 patients had persistence in their pharmacy records (21%). Persistence of the penicillin allergy label was not significantly associated with age (p50.73), gender (p50.35), or whether the evaluation was done inpatient or outpatient (p50.88). Follow-up telephone survey was done with 24 patients (nine patients were unavailable for follow-up), and 96% (n523) recalled the results of their allergy evaluation correctly. Despite accurate recall, 3 patients continued to avoid penicillin for fear of a possible reaction. CONCLUSIONS: This study found that while penicillin allergy delabeling is safe and effective, there is a discrepancy between the allergy evaluation and the appropriate removal of the penicillin allergy from the EMR and pharmacy records, which may include patient apprehension as a cause. Neither age, gender, nor place of evaluation predicted persistence of the penicillin allergy label.