Annals of Allergy Asthma & Immunology最新文献

{"title":"Evaluation of the PEN-FAST clinical decision rule in non–beta-lactam antibiotic allergy assessment","authors":"Deniz Göcebe MD ,&nbsp;Elham Khatamzas MD ,&nbsp;Alexander Enk MD ,&nbsp;Knut Schäkel MD","doi":"10.1016/j.anai.2025.06.019","DOIUrl":"10.1016/j.anai.2025.06.019","url":null,"abstract":"<div><h3>Background</h3><div>False antibiotic allergy labels lead to the unnecessary use of broad-spectrum agents, contributing to antimicrobial resistance and poorer clinical outcomes. Penicillin allergy delabeling initiatives have been supported by validated clinical decision rules such as PEN-FAST. However, there are currently no available standardized approaches for non–beta-lactam allergies, for which standardized and validated skin tests are also lacking.</div></div><div><h3>Objective</h3><div>First, to validate the safety and negative predictive value (NPV) of PEN-FAST for penicillin allergies. Second, to evaluate whether the performance of PEN-FAST could be replicated for non–beta-lactam antibiotic allergy labels.</div></div><div><h3>Methods</h3><div>This retrospective single-center comparative cohort study analyzed adult patients with penicillin or non–beta-lactam allergy labels referred to our allergy division at the Department of Dermatology, Heidelberg, Germany. Allergy assessment included skin tests and subsequent drug challenge. The performance of the previously published PEN-FAST criteria was evaluated for both cohorts.</div></div><div><h3>Results</h3><div>A total of 102 penicillin allergy and 191 non–beta-lactam labels were analyzed. Confirmed allergies were more prevalent among non–beta-lactams (50.3% vs 37.3%). PEN-FAST exhibited high sensitivity for both penicillin (97.4%) and non–beta-lactams (94.8%), with an NPV of 95.8% and 82.8%, respectively. Misclassifications were limited to mild cutaneous reactions. Excluding clindamycin labels increased the NPV for non–beta-lactams to 95%.</div></div><div><h3>Conclusion</h3><div>Despite lower NPV for non–beta-lactam labels and varying performance across antibiotic classes, our results indicate that PEN-FAST may serve as a safe risk stratification tool for non–beta-lactam allergy labels. Prospective studies with direct drug challenges are required to assess its utility in the delabeling of non–beta-lactam allergies.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 443-447.e3"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving closer toward personalized management of drug allergy","authors":"Anna Nowak-Wegrzyn MD, PhD ,&nbsp;Francesca Levi-Schaffer PharmD, PhD, FRCP Hon","doi":"10.1016/j.anai.2025.08.002","DOIUrl":"10.1016/j.anai.2025.08.002","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 355-356"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and phenotype of food allergy in children with cystic fibrosis","authors":"Hang P. Nguyen BS ,&nbsp;Veronika Shabanova PhD ,&nbsp;Sarah McCollum MPH ,&nbsp;Brooke Polk MD ,&nbsp;Tricia Lee MD ,&nbsp;Kyle Whittington MD ,&nbsp;Priscila Cunha MD ,&nbsp;Emanuela M. Bruscia PhD ,&nbsp;Marie E. Egan MD ,&nbsp;Marc Emmenegger PhD ,&nbsp;Stephanie Leeds MD, MHS","doi":"10.1016/j.anai.2025.06.024","DOIUrl":"10.1016/j.anai.2025.06.024","url":null,"abstract":"<div><h3>Background</h3><div>Nonspecific gastrointestinal symptoms associated with cystic fibrosis (CF) may be misdiagnosed as food allergy (FA). There is a paucity of data regarding the prevalence and phenotype of IgE–mediated FA in CF.</div></div><div><h3>Objective</h3><div>To determine the prevalence and characteristics of pediatric FA in CF.</div></div><div><h3>Methods</h3><div>We conducted a retrospective pediatric cohort study using the CF foundation registries and electronic medical records from (redacted names A and B). Demographic, biometric, and medical information were collected, and individuals suspected of having FA were identified through multiple inclusion criteria. A convincing FA diagnosis was established on the basis of a priori criteria, including medical history, testing results, and management. The estimated prevalence was calculated as a percentage and compared with the most recently reported pediatric FA prevalence in the United States.</div></div><div><h3>Results</h3><div>Among 289 patients (51.21% male sex, median age = 12.40 years), 11 (3.81%, 95% CI 1.91-6.71) had at least 1 convincing FA, yielding a smaller prevalence than the most recent estimate in the US pediatric population (7.60%, 95% CI 7.10-8.10, <em>P</em> = .015). Male patients with CF (6.08% vs 1.42%, <em>P</em> = .038) and patients without pancreatic enzyme replacement (9.09% vs 2.25%, <em>P</em> = .020) had a higher prevalence of convincing FA.</div></div><div><h3>Conclusion</h3><div>Our study of pediatric patients with CF found a lower prevalence of FA compared with the general pediatric population in the United States. Stringent criteria should be used when labeling patients with CF who have FA to minimize overdiagnosis. Further studies are needed to investigate whether CF could potentially be protective against the development of FA.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 419-424"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 2 biomarkers and airway hyper-responsiveness disconnect in patients with uncontrolled severe asthma taking benralizumab or dupilumab","authors":"Robert Greig MbChB,&nbsp;Rory Chan PhD,&nbsp;Brian Lipworth MD","doi":"10.1016/j.anai.2025.07.024","DOIUrl":"10.1016/j.anai.2025.07.024","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 448-449"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab efficacy in relation to changes in club cell secretory protein 16","authors":"Hao-Yun Chen MD ,&nbsp;Yi-Hsuan Tu MD ,&nbsp;Yun-Cheng Tsai MD ,&nbsp;Su-Boon Yong MD, PhD ,&nbsp;Chin-Yuan Yii MD","doi":"10.1016/j.anai.2025.05.027","DOIUrl":"10.1016/j.anai.2025.05.027","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 458-459"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"10 ways to improve emergency preparedness for patients with allergy while flying","authors":"Sangeetha M. Kodoth MD ,&nbsp;Niraj C. Patel MD, MS ,&nbsp;Hyun J. Park MD, PhD ,&nbsp;Joel P. Brooks DO, MPH","doi":"10.1016/j.anai.2025.06.025","DOIUrl":"10.1016/j.anai.2025.06.025","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 464-465"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe asthma and new-onset meat allergy in a child: Could a new puppy be to blame?","authors":"Gauri Misra MD ,&nbsp;Rebecca Grohman DO ,&nbsp;Mikhail Kazachkov MD ,&nbsp;Anna Nowak-Wegrzyn MD, PhD","doi":"10.1016/j.anai.2025.06.033","DOIUrl":"10.1016/j.anai.2025.06.033","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 363-365"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroid stewardship","authors":"Stanley J. Szefler MD","doi":"10.1016/j.anai.2025.07.026","DOIUrl":"10.1016/j.anai.2025.07.026","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 359-360"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Birch!","authors":"Erin L. Reigh MD, MS","doi":"10.1016/j.anai.2025.05.014","DOIUrl":"10.1016/j.anai.2025.05.014","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 383-384"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of remote therapeutic monitoring to increase inhaled corticosteroid adherence in children with high-risk asthma","authors":"Linda E. Mendoza DNP, CPNP, AE-C ,&nbsp;Clarisse G. Casilang MD ,&nbsp;Tricia Morphew MS ,&nbsp;Jennifer Barrows PhD, RN ,&nbsp;Paulina Schuhler MSN, RN ,&nbsp;Stanley P. Galant MD","doi":"10.1016/j.anai.2025.07.016","DOIUrl":"10.1016/j.anai.2025.07.016","url":null,"abstract":"<div><h3>Background</h3><div>Asthma can be well-controlled with the use of inhaled corticosteroids (ICS), but most children and adolescents do not adhere to recommended treatment, leading to exacerbations, emergency department visits, hospitalizations, and deaths. Remote therapeutic monitoring (RTM) has demonstrated potential to increase ICS adherence and improve asthma outcomes, but few studies have been conducted in young people, and lack of research in minority groups may contribute to health disparities.</div></div><div><h3>Objective</h3><div>To evaluate the feasibility of RTM in children and adolescents who receive asthma care at an urban mobile clinic serving a predominantly Hispanic population.</div></div><div><h3>Methods</h3><div>A total of 20 children aged 5 to 17 years participated in RTM for 6 months. Feasibility evaluation included recruitment, retention, implementation factors, and participant and provider satisfaction. ICS adherence and asthma-related outcomes were assessed monthly and analyzed descriptively.</div></div><div><h3>Results</h3><div>Of 24 eligible participants, 20 (83%) were recruited and 19 (95%) completed the study. Participants found RTM satisfactory with a mean rating of 4.6 of 5. Although some encountered practical challenges, 10 of 14 respondents (71%) indicated that they would continue using RTM. Providers rated their satisfaction 4 of 5, but RTM did not consistently meet patient needs, nor was it well-integrated with their workflow. Overall mean ICS adherence was 53%, and patients requiring emergency department visits decreased from 10 at baseline to 5 during the intervention.</div></div><div><h3>Conclusion</h3><div>RTM is feasible in underserved children with asthma, but implementation requires additional support from clinical staff. Further research is needed to determine efficacy.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 4","pages":"Pages 393-402"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}