Clinical Outcome Associated With Beta-Lactam Allergy Labels in Hospitalized Patients in Belgium

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2026-03-27 DOI:10.1002/clt2.70166

Liesbeth Gilissen, Greet Van De Sijpe, Annouschka Laenen, Peter Declercq, Dries Wets, Ileana Ghiordanescu, Anca Mirela Chiriac, Willy E. Peetermans, Paul De Munter, Isabel Spriet, Rik Schrijvers

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Abstract

Background

In the United States, beta-lactam allergy labels (BLAL) are documented in 9%–16% of hospitalized patients and associated with worse clinical outcomes such as increased mortality, length of hospital stay (LOS), intensive care unit (ICU) admission, and use of alternative antibiotics, providing an incentive for broad delabeling protocols. In Europe, BLAL prevalences are lower (0.6%–5%) and the association with clinical outcomes insufficiently explored. Therefore, we assessed the association between BLAL and penicillin allergy label (PenAL) and clinical outcomes and antibiotic use in hospitalized patients in Belgium.

Methods

Retrospective population-based cohort study of all patients admitted to the University Hospitals Leuven between 2010 and 2018 for pneumonia, pyelonephritis (therapeutic indications), or appendectomy, coronary artery bypass grafting, total knee or hip replacement (prophylactic indications) or heart, kidney, liver, or lung transplantation (mixed indications). Multivariable regression analysis was performed, using BLAL or PenAL as independent variable, and age, gender, Charlson Comorbidity Index, and diagnosis as a priori hypothesized confounders.

Results

We included 21,999 patients accounting for 23,842 admissions. A BLAL was recorded in 1394 (6.3%) patients, with 1113 (5.1%) having an unspecified PenAL. An increased use of next-line antibiotics was observed among patients with BLAL or PenAL. However, BLAL or PenAL were not associated with altered in-hospital or 3-month post-hospitalization mortality, LOS or ICU admission.

Conclusion

Despite altered antibiotic use, we observed no association of BLAL or PenAL with clinical outcome parameters, highlighting regional differences and limiting transferability of non-EU findings to guide EU delabeling protocols.

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比利时住院患者β -内酰胺过敏标签相关的临床结果

背景：在美国，9%-16%的住院患者记录了β -内酰胺过敏标签（BLAL），并与较差的临床结果相关，如死亡率增加、住院时间（LOS）、重症监护病房（ICU）入院和使用替代抗生素，这为广泛的去标签方案提供了动力。在欧洲，BLAL患病率较低（0.6%-5%），其与临床结果的关系尚未得到充分探讨。因此，我们评估了比利时住院患者BLAL和青霉素过敏标签（PenAL）与临床结局和抗生素使用之间的关系。方法：回顾性人群队列研究，纳入2010年至2018年间在鲁汶大学医院接受肺炎、肾盂肾炎（治疗指征）、阑尾切除术、冠状动脉搭桥术、全膝关节或髋关节置换术（预防指征）或心、肾、肝或肺移植（混合指征）治疗的所有患者。进行多变量回归分析，以BLAL或PenAL为自变量，年龄、性别、Charlson合并症指数和诊断为先验假设混杂因素。结果：我们纳入了21,999例患者，其中23,842例入院。1394例（6.3%）患者有BLAL记录，1113例（5.1%）患者有未明确的刑事处罚。在BLAL或PenAL患者中观察到二线抗生素的使用增加。然而，BLAL或PenAL与院内或住院后3个月死亡率、LOS或ICU住院率的改变无关。结论：尽管改变了抗生素的使用，我们观察到BLAL或PenAL与临床结果参数没有关联，突出了区域差异，限制了非欧盟研究结果的可转移性，以指导欧盟的去标签协议。

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

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.