Alergia a la penicilina: una etiqueta que no es para siempre

Pub Date : 2024-06-26 DOI:10.1016/j.semerg.2024.102280
Á. Morales Martínez
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引用次数: 0

Abstract

Self-reported penicillin allergy is highly prevalent. Different studies estimate that 10% of the population is labeled as such.

This label, confirmed or suspected, forces us to take precautions and replace the antibiotic treatment of choice (frequently beta-lactams) with other 2 nd or 3 rd choice alternatives with worse overall results: side effects, resistance, costs, etc.

The penicillin allergy label, once placed, remains in the medical record. It is only confirmed in less than 5% of patients, either because it has been placed inappropriately or because over time the sensitivity decreases and may disappear.

Penicillin Allergy Decision Rule –PEN-FAST– is a validated and simple clinical prediction rule that estimates the risk of presenting an allergic reaction. Its use, together with algorithms that involve primary care in the study and delabeling of low-risk patients, can change our clinical practice.

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[青霉素过敏:不是永远的标签]。
自我报告的青霉素过敏症非常普遍。据不同的研究估计,有 10% 的人被贴上了青霉素过敏的标签。这种标签,无论是被证实还是被怀疑,都迫使我们采取预防措施,并用其他第二或第三选择的替代品取代首选的抗生素治疗(通常是β-内酰胺类),而这些替代品在副作用、耐药性、成本等方面的总体效果更差。青霉素过敏标签一旦贴上,就会保留在病历中。只有不到 5%的患者能确认对青霉素过敏,原因可能是标签贴得不恰当,也可能是随着时间的推移,敏感性降低并可能消失。青霉素过敏决策规则--PEN-FAST--是一种经过验证的简单临床预测规则,用于估计出现过敏反应的风险。它的使用以及让初级保健参与低风险患者的研究和脱敏的算法可以改变我们的临床实践。
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