Prevalence of beta-lactam allergy: a retrospective chart review of drug allergy assessment in a predominantly pediatric population

Abstract

BackgroundResearch suggests that 90% of patients labeled beta-lactam allergic are able to tolerate penicillins following further assessment. This study aims to define and describe the frequency of true beta-lactam allergy following allergy patient evaluation in a predominantly pediatric population.Methods306 primary care patients referred between January 2010 and June 2015 were assessed for a suspected beta-lactam allergy. Patient demographics, history and test results were extracted from electronic medical records. Testing performed was based on specialist recommendation following review of patient history.Results34% of the study participants had intradermal testing. Oral challenge was given to 96.7% of the sample. 96% of patients with a prior history of beta-lactam allergy were advised that they could re-introduce beta-lactam antibiotics following evaluation.ConclusionsAmong patients with a documented beta-lactam allergy or a recent history of a reaction there is a low rate of ‘true’ beta-lactam allergy. Consistent evaluation of beta-lactam antibiotic allergies can reduce rates of broad spectrum antibiotic prescribing, among other harmful consequences.

Should testing be initiated prior to amoxicillin challenge in children?

“…Up to 10% of children in North America and Europe are labelled as amoxicillin allergic . However, approximately 90%‐99% of children labelled as allergic can tolerate amoxicillin after allergy evaluation . This may be largely explained by the common occurrence of viral‐induced delayed exanthems and viral urticaria in children, which are often mislabelled as allergic reactions to amoxicillin .…”

“…This article, in contrast to previous articles on the use of testing in beta‐lactam allergy, will focus specifically on amoxicillin instead of more broadly at the beta‐lactam class of antibiotics, as it is the most common beta‐lactam prescribed in children. In addition, as 5%‐10% of children with exposure to amoxicillin will develop an exanthem, it is the beta‐lactam most commonly implicated as a cause of drug allergy in the paediatric population …”

Diagnosing and managing drug allergy

“…29 In a 2016 Canadian retrospective chart review involving 306 patients in primary care, β-lactam allergy was ruled out in 96.1% (95% CI 93.2%-97.5%) of patients after β-lactam allergy evaluation. 30 Some studies have suggested that the rate of confirmed penicillin allergy is decreasing. 31,32 Recent initiatives have suggested What was the time frame of the reaction?…”

ASSOCIATION OF INTERLEUKIN-4 CYTOKINE AND IL-4Rα GENE POLYMORPHISM IN Β-Lactam ALLERGIC PATIENTS

“…Other 50 apparently healthy subjects (13 males and 37 female) they were included as a control group; blood samples were collected from both groups. Skin testing was done with Benzylpenicillin (PG) using SPT on inner of forearms with a concentration of reagent up to 10000 IU/ml (15,9,16,17). The reaction read after 15-20 min it considered +ve when a wheel diameter was ≥3 mm with surrounding areas of erythema.…”

“…About 10-20% of total population has been marked as allergic to penicillin [7]. However, it has been reported that over 90% of BLs allergic patients were proven to be able to tolerate penicillin antibiotic when administered [8,9]. Penicillin hypersensitivity is mainly related to specific immunological reactions, that being classified as immediately and noon immediate reaction [10].…”