Drug allergies in the surgical population

Hung, Orlando; Bands, Colin; Laney, Geoffrey; Drover, David R.; Stevens, Sarah; MacSween, Michael J.

doi:10.1007/bf03020652

Cited by 45 publications

(36 citation statements)

References 10 publications

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“…Although many patients have drug allergies documented in their medical records, the symptoms or circumstances associated with the allergies are rarely documented. Several studies have demonstrated that the incidence of true drug "allergy" is lower than that recorded in medical records [33][34][35]. Because b-lactam antimicrobials often represent agents of choice for prophylaxis, the medical history should be adequate to determine if the patient likely had a true allergy (e.g., urticaria, pruritus, angioedema, bronchospasm, hypotension, or arrhythmia) or a serious adverse drug reaction (e.g., drug-induced hypersensitivity syndrome, drug fever, or toxic epidermal necrolysis) [36].…”

Section: General Recommendationsmentioning

confidence: 99%

Antimicrobial Prophylaxis for Surgery: An Advisory Statement from the National Surgical Infection Prevention Project

Dale

Peter²

2004

Clinical Infectious Diseases

781

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In January 2003, leadership of the Medicare National Surgical Infection Prevention Project hosted the Surgical Infection Prevention Guideline Writers Workgroup (SIPGWW) meeting. The objectives were to review areas of agreement among the most-recently published guidelines for surgical antimicrobial prophylaxis, to address inconsistencies, and to discuss issues not currently addressed. The participants included authors from most of the groups that have published North American guidelines for antimicrobial prophylaxis, as well as authors from several specialty colleges. Nominal group process was used to draft a consensus paper that was widely circulated for comment. The consensus positions of SIPGWW include that infusion of the first antimicrobial dose should begin within 60 min before surgical incision and that prophylactic antimicrobials should be discontinued within 24 h after the end of surgery. This advisory statement provides an overview of other issues related to antimicrobial prophylaxis, including specific suggestions regarding antimicrobial selection.

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Section: General Recommendationsmentioning

confidence: 99%

Antimicrobial Prophylaxis for Surgery: An Advisory Statement from the National Surgical Infection Prevention Project

Dale

Peter²

2004

Clinical Infectious Diseases

781

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“…As in previous Western reports, allergy to antibiotics was the most frequent drug allergy, 1 particularly in university students, 5 and drug allergy (excluding chloroquine) was more frequent in women. [8][9][10] Students from health-related courses had a higher risk of drug allergy than other students, possibly reflecting easier access to medicines and a higher probability of sensitization.…”

mentioning

confidence: 99%

Self-reported food and drug allergy in Maputo, Mozambique

et al. 2005

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There is wide regional variation in the prevalence of drug 1 and food 2,3 allergy. Although no data are available from developing countries, allergy frequency is expected to differ from that observed in more affluent regions, reflecting the genetic background, and the cultural and economic influences on exposure to allergens. This is the first report on prevalence estimates for food and drug allergy in an African country.Students (nZ447; one-third of all those registered; 44.7% male; age range: 18-56 years; median age: 25 years) and non-teaching staff (nZ62; 43.5% male; age range: 23-60 years; median age: 32 years) at a private university in Maputo volunteered to participate in a cross-sectional health survey with the main focus on the evaluation of risk factors for cardiovascular diseases, namely smoking, drinking, obesity and blood pressure. The questions 'Are you allergic to any food/drug?' and 'If yes, which food(s)/drug(s) are you allergic to?' were added to the questionnaire to ascertain allergy.Most participants (96.8%) were born in Mozambique, and were asked specifically about their place of birth. This was subsequently grouped into Maputo (Maputo city and Maputo province), South (provinces of Gaza and Inhambane), Centre (provinces of Manica, Sofala, Tete and Zambezia) and North (provinces of Nampula, Niassa and Cabo Delgado). Ethnicity was determined by self-identification, and participants were classified as either black or nonblack for data analysis.Odds ratios with 95% confidence intervals were computed to quantify the association between food/drug allergy and sociodemographic factors.The life prevalence of self-reported food allergy was 19.1%, and seafood (54.8%), meat (13.0%) and fruit/vegetables (13.0%) were the most frequently reported items. Food allergy decreased with age, from 22.6% in participants below 25 years of age to 12.0% in those above 35 years of age (P for trendZ0.03).

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“…Patients are frequently prescribed opioids, despite a supposed allergy, without explanatory documentation in the medical record. 1,2 In a previous study, 1 we found that 70% (21/30) of patients were prescribed opioid drugs during admission despite professing an allergy to that class of medications. The aim of this current study was to assess how health professionals would manage a patient labelled as opioid allergic.…”

Section: Introductionmentioning

confidence: 94%

History of opioid allergy: what significance?

Gilbar

Ridge

2004

J Oncol Pharm Pract

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Objective. To assess how health professionals would manage a patient’s pain when the patient is labelled as allergic to opioid analgesics. Methods. A clinical case scenario, describing a patient obviously requiring opioid pain management but reporting a morphine allergy, was designed and pretested. This was distributed to medical (students, interns/residents, registrars, consultants) and nursing staff of Toowoomba Health Service District. All staff had some experience in pain management, though this varied widely. Respondents were asked to review the history and briefly comment on how the patient’s pain should be managed. Results. Overall response rate was 46%. Doctors returned 47% (39/83) of scenarios, with 53% requesting further information on the nature of the allergy before using opioids. Nurses response rate was 45.2% (42/93), with only 21.4% requesting more information. Eighty three per cent (15/18) of doctors and 60% (20/33) of nurses, who didn’t query the nature of the morphine allergy, recommended opioid medication. No one specifically suggested using structurally dissimilar opioids to morphine if an allergy really existed. Conclusion. Many health care staff either missed or ignored the allergy or assumed it was really an adverse effect and not significant, potentially placing the patient at risk of serious consequences, including anaphylaxis. Despite the low incidence of true opioid allergy, health professionals must fully investigate purported allergies to determine their validity. Patients should never be administered medications until their likelihood of experiencing a true allergy is determined.

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Drug allergies in the surgical population

Abstract: Many patients claim to have drug allergies. However, the signs and symptoms of "allergic reactions" are seldom documented and the drug allergies are rarely properly assessed. The goal of this study was to determine the incidence of claimed "drug allergies" in a surgical population. After

Cited by 45 publications

References 10 publications

Antimicrobial Prophylaxis for Surgery: An Advisory Statement from the National Surgical Infection Prevention Project

Antimicrobial Prophylaxis for Surgery: An Advisory Statement from the National Surgical Infection Prevention Project

Self-reported food and drug allergy in Maputo, Mozambique

History of opioid allergy: what significance?

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