Algorithms for the classification of patients with a β-lactam allergy label: a systematic review.

IF 3 4区医学 Q2 ALLERGY

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-08-01 Epub Date: 2025-06-20 DOI:10.1097/ACI.0000000000001086

Joana Sousa, Joana Balseiro, Mariana Barreto, Francisca Mendes, Ana Margarida Pereira, Inês Ribeiro-Vaz, Ricardo Cruz-Correia, Bernardo Sousa-Pinto

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引用次数: 0

Abstract

Purpose of review: Beta-lactam allergy is frequently reported, but only a minority of cases correspond to true allergies. Tools to stratify the risk of a real allergic reaction can possibly help delabeling patients. We aimed to retrieve evidence on algorithms for risk stratification of patients with a beta-lactam allergy label.

Recent findings: We performed a systematic review, searching three databases and included 28 studies. Most of the applied tools involved the assessment of the presence of rash/hives/other exanthemas ( n = 24), angioedema/localized swelling ( n = 23), bronchospasm/wheezing/dyspnea ( n = 22) and gastrointestinal symptoms ( n = 21). Seventeen studies classified participants into different categories according to their risk of having a penicillin allergy; three studies presented algorithms indicating management approaches to be followed; six studies applied predictive models. Most studies had a high risk of bias, particularly concerning the reference standard and lack of external validation.

Summary: Existing algorithms for beta-lactam allergy risk stratification are very heterogeneous and most of them lack validation.

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β-内酰胺过敏标签患者的分类算法：系统综述。

回顾目的：β -内酰胺过敏经常被报道，但只有少数病例符合真正的过敏。对真正过敏反应的风险进行分层的工具可能有助于患者去除标签。我们的目的是检索具有β -内酰胺过敏标签的患者的风险分层算法的证据。最新发现：我们进行了系统回顾，检索了三个数据库，包括28项研究。大多数应用的工具包括评估皮疹/荨麻疹/其他皮疹（n = 24）、血管性水肿/局部肿胀（n = 23）、支气管痉挛/喘息/呼吸困难（n = 22）和胃肠道症状（n = 21）的存在。17项研究根据受试者对青霉素过敏的风险将其分为不同的类别；三项研究提出了表明应遵循的管理方法的算法；6项研究应用了预测模型。大多数研究存在高偏倚风险，特别是在参考标准和缺乏外部验证方面。摘要：现有的β -内酰胺过敏风险分层算法非常不均匀，大多数缺乏验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Allergy and Clinical Immunology 医学-过敏

CiteScore

5.90

自引率

3.60%

发文量

109

审稿时长

6-12 weeks

期刊介绍： This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on one to three topics, every issue of Current Opinion in Allergy and Clinical Immunology delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as upper airway disease; mechanisms of allergy and adult asthma; paediatric asthma and development of atopy; food and drug allergies; and immunotherapy.