Self‐reported drug allergy in a general adult Portuguese population

Abstract

SummaryAim To estimate the prevalence of self-reported drug allergy in adults. Methods Cross-sectional survey of a general adult population from Porto (all of whom were living with children involved in the International Study of Asthma and Allergies in Childhood-phase three), during the year 2002, using a self-administered questionnaire. Results The prevalence of self-reported drug allergy was 7.8% (181/2309): 4.5% to penicillins or other b-lactams, 1.9% to aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) and 1.5% to other drugs. In the group 'allergic to b-lactams', the most frequently implicated drug was penicillin G or V (76.2%) followed by the association of amoxicillin and clavulanic acids (14.3%). In the group 'allergic to NSAIDs', acetylsalicylic acid (18.2%) and ibuprofen (18.2%) were the most frequently identified drugs, followed by nimesulide and meloxicam. Identification of the exact name of the involved drug was possible in less than one-third of the patients, more often within the NSAID group (59.5%). Women were significantly more likely to claim a drug allergy than men (10.2% vs. 5.3%). The most common manifestations were cutaneous (63.5%), followed by cardiovascular symptoms (35.9%). Most of the reactions were immediate, occurring on the first day of treatment (78.5%). Only half of the patients were submitted to drug allergy investigations. The majority (86.8%) completely avoided the suspected culprit drug thereafter. Conclusions The results showed that self-reported allergy to drugs is highly prevalent and poorly explored. Women seem to be more susceptible. b-lactams and NSAIDs are the most frequently concerned drugs.

Immediate Reactions to More Than 1 NSAID Must Not Be Considered Cross-Hypersensitivity Unless Tolerance to ASA Is Verified

“…From a total of 203 patients with immediate SRs to NSAIDs, we identified 16 who reacted to 2 or 3 chemically unrelated NSAIDs and were tolerant to ASA. In contrast to hypersensitivity to BLs [21,31], patients with DHRs to NSAIDs often experience repeated episodes as a result of incomplete knowledge about how to address the reactions [8,32]. Although multiple allergy to drugs was first reported more than 20 years ago [19,20], studies to elucidate the mechanism have been carried out only for T cell-dependent reactions, where sensitization to multiple drugs could occur both simultaneously and sequentially [19][20][21].…”

“…Concentrations were used as previously reported [29][30][31]. The basophil activation test (BAT) was performed exclusively for pyrazolone derivatives as described elsewhere [27].…”

Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management: review of the EAACI/ENDA# and GA2LEN/HANNA*

“…Aspirin (ASA) hypersensitivity affects from 0.5% to 1.9% of the general population (5,6). Prevalence of hypersensitivity to NSAIDs among adult asthmatic patients assessed by questionnaires or medical records is ranging from 4.3% to 11% (7) and can be as high as 21% if diagnosis includes provocation tests (8).…”

Alergia a Medicamentos Reportada em Crianças que Frequentam Infantários

“…Existem poucos estudos publicados sobre a prevalência de alergia a medicamentos na criança, 8,10,23 e em particular em crianças com idade inferior a seis anos. Contudo, a literatura existente sugere que, à semelhança do que acontece noutras faixas etárias, 24 somente uma minoria daqueles que reportam alergia serão verdadeiramente alérgicos.…”

“…1,9 Sabe-se que quando a história de alergia a um medicamento é complementada pela realização de testes cutâneos ou através de prova de provocação oral, a grande maioria tolerará o medicamento sem qualquer reação. 8,10,11 Este estudo teve como objetivo principal estimar a prevalência de alergia a medicamentos reportada numa amostra de crianças que frequenta infantários de Lisboa e do Porto, procurando ainda identificar variáveis associadas com a alergia reportada.…”