Low-risk cefalexin allergies are associated with inpatient prescribing of second-line non-beta-lactam antibiotics

Q3 Medicine

Allergo Journal International Pub Date : 2023-06-06 DOI:10.1007/s40629-023-00250-z

Melinda Jiang MD, Stephen Bacchi PhD, Lydia Lam, Antoinette Lam, Joshua M. Inglis MBBS, Toby Gilbert MB BCh BAO, Samuel Gluck PhD, Sepehr Shakib PhD, Chino Yuson MBBS, William Smith PhD

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引用次数: 0

Abstract

Background

Cefalexin is a commonly prescribed oral antibiotic, with a similar side chain to amoxicillin. The objectives of this study were to (1) describe the frequency and nature of previously recorded cefalexin adverse reaction (AR) labels in the electronic medical record (EMR) in a medical inpatient cohort, (2) evaluate the accuracy of these labels and (3) examine the association between a cefalexin allergy label and the antibiotics prescribed during an inpatient admission.

Methods

Consecutive admissions under general medicine in a tertiary hospital over a 1-year period were included in this retrospective cohort study. Data regarding cefalexin adverse reaction (AR) history, and antibiotics prescribed during admission were collected from the EMR. Cefalexin allergy descriptions were reviewed using expert criteria to determine whether the described reaction was most consistent with allergy or intolerance.

Results

The number of admissions included in this study was 12,134. Of the 224 (1.9%) admissions with a recorded cefalexin AR, 196 (87.5%) had a label of allergy and 28 (12.5%) of intolerance. Following the application of expert criteria, 43 (21.9%) of cefalexin allergy labels were found to be consistent with intolerance. The presence of a low-risk cefalexin allergy was associated with an increased likelihood of receiving non-penicillin antibiotics including clindamycin and ciprofloxacin.

Conclusion

Cefalexin AR are common, and frequently incorrectly classified in the electronic medical record with consequences for in-hospital antibiotic prescribing and antimicrobial stewardship.

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低风险头孢氨苄过敏与住院患者开具二线非β-内酰胺类抗生素处方有关

背景头孢氨苄是一种常用的口服抗生素，其副作用链与阿莫西林相似。本研究的目的是：(1) 描述一个住院病人队列的电子病历（EMR）中以前记录的头孢氨苄不良反应（AR）标签的频率和性质；(2) 评估这些标签的准确性；(3) 研究头孢氨苄过敏标签与住院期间处方抗生素之间的关联。从电子病历中收集有关头孢氨苄不良反应（AR）病史和入院时处方抗生素的数据。使用专家标准对头孢氨苄过敏描述进行审查，以确定描述的反应最符合过敏还是不耐受。在 224 例（1.9%）有头孢氨苄 AR 记录的入院患者中，196 例（87.5%）标注为过敏，28 例（12.5%）标注为不耐受。根据专家标准，有 43 例（21.9%）头孢氨苄过敏病例与不耐受病例一致。低风险头孢氨苄过敏与接受非青霉素类抗生素（包括克林霉素和环丙沙星）的可能性增加有关。

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

Allergo Journal International Medicine-Immunology and Allergy

CiteScore

4.60

自引率

0.00%

发文量

期刊介绍： Allergo Journal International is the official Journal of the German Society for Applied Allergology (AeDA) and the Austrian Society for Allergology and Immunology (ÖGAI). The journal is a forum for the communication and exchange of ideas concerning the various aspects of allergy (including related fields such as clinical immunology and environmental medicine) and promotes German allergy research in an international context. The aim of Allergo Journal International is to provide state of the art information for all medical and scientific disciplines that deal with allergic, immunological and environmental diseases. Allergo Journal International publishes original articles, reviews, short communications, case reports, and letters to the editor. The articles cover topics such as allergic, immunological and environmental diseases, the latest developments in diagnosis and therapy as well as current research work concerning antigens and allergens and aspects related to occupational and environmental medicine. In addition, it publishes clinical guidelines and position papers approved by expert panels of the German, Austrian and Swiss Allergy Societies. All submissions are reviewed in single-blind fashion by at least two reviewers. Originally, the journal started as a German journal called Allergo Journal back in 1992. Throughout the years, English articles amounted to a considerable portion in Allergo Journal. This was one of the reasons to extract the scientific content and publish it in a separate journal. Hence, Allergo Journal International was born and now is the international continuation of the original German journal. Nowadays, all original content is published in Allergo Journal International first. Later, selected manuscripts will be translated and published in German and included in Allergo Journal.