Prevalence and risk assessment of drug allergies in hospitalized patients: Potential for allergy delabeling

Background

Drug allergy prevalence is high and predicted to rise in the future. Although allergy labels are essential for patient safety, evidence supports the fact that incorrectly recorded drug allergy labels might lead to suboptimal treatments, increased healthcare costs, prolonged hospital stays, and the emergence of antimicrobial resistance (AMR). Drug allergy risk assessment and subsequent delabeling could be a solution for this problem. Despite the importance of this subject, the number of studies on the prevalence of drug allergies or delabeling is low, especially from Eastern European countries.

Aims

This study aimed to determine the prevalence and characteristics of drug allergies in hospitalized patients and assess the associated risk of future exposure to the reported culprit drugs to evaluate the potential for allergy delabeling.

Methods

A cross-sectional study was conducted at the tertiary care teaching hospital of University of Szeged in Hungary, involving adult inpatients across multiple surgical wards. Data collection included patient interviews using a structured questionnaire and subsequent risk assessment. Adverse drug reactions were categorized as high or low risk based on the history of the reported reaction.

Results

Of the 1522 study participants, 242 (15.90 %, 95 % CI: 14.14 - 17.82 %) patients reported at least one drug allergy, resulting in a total of 384 reported allergy cases. Among these, 277 cases were included in the risk assessment, with 252 (90.97 %) classified as low risk and eligible for potential allergy delabeling. Antibiotics were the most frequently reported culprit drug, followed by analgesics and anti-inflammatory drugs. Skin manifestations were the most common symptoms.

Conclusion

This study highlights the high prevalence of self-reported drug allergies and the significant proportion of low-risk cases suitable for delabeling. Systematic allergy evaluation and delabeling should be a key element of (antibiotic) stewardship programs.