青霉素过敏去标签项目的有效性——来自克罗地亚的真实数据。

IF 2.1 4区 医学 Q3 ALLERGY
Allergologia et immunopathologia Pub Date : 2025-09-01 eCollection Date: 2025-01-01 DOI:10.15586/aei.v53i5.1360
Ivan Marković, Jelena Barišić, Marina Božan Aksentijević, Ivica Lokner, Vesna Vukičević Lazarević
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引用次数: 0

摘要

青霉素过敏是最常见的药物过敏,通常导致不必要地避免使用β -内酰胺类抗生素,增加使用替代广谱抗生素,并增加医疗保健费用。然而,研究表明,超过90%的青霉素过敏标签是错误的。本研究展示了克罗地亚萨格勒布肺病专科医院进行的青霉素过敏去标签项目的真实数据。采用分步诊断方案对132例报告有β -内酰胺过敏的成人患者进行评估,包括病史回顾、皮肤试验、特异性IgE和药物激发试验。5名患者直接去标签,127名患者接受诊断检测。在121名完成方案的参与者中,13名(10.74%)患者确诊为青霉素过敏,另外3名患者因有高危史而保留了青霉素过敏标签,总体确诊过敏率为13.2%。即刻反应和延迟反应的STs阴性预测值分别为99.07%和94.39%,而即刻反应的sIgE NPV为100%。诊断过程中未发生严重反应。132例患者中有105例(79.5%)安全地去标签。这些发现证实了门诊PAD项目的安全性和有效性,并强调了通过减少不必要的β -内酰胺避免来改善抗生素管理的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of a penicillin allergy delabeling program-real-world data from Croatia.

Penicillin allergy is the most commonly reported drug allergy, often leading to unnecessary avoidance of beta-lactam antibiotics, increased use of alternative broad-spectrum antibiotics, and higher healthcare costs. However, studies indicate that over 90% of penicillin allergy labels are erroneous. This study presents real-world data from a penicillin allergy delabeling program conducted at the Special Hospital for Pulmonary Diseases in Zagreb, Croatia. A total of 132 adult patients with a reported beta-lactam allergy were evaluated with a stepwise diagnostic protocol, including medical history review, skin tests, specific IgE, and drug provocation tests. Five patients were delabeled directly, while 127 underwent diagnostic testing. Among 121 participants who completed the protocol, penicillin allergy was confirmed in 13 (10.74%) patients, and the label was retained in an additional 3 patients because of high-risk history, resulting in an overall confirmed allergy rate of 13.2%. The negative predictive values for STs were 99.07% and 94.39% for immediate and delayed reactions, respectively, while the NPV of sIgE for immediate reactions was 100%. No severe reactions occurred during the diagnostic process. Hundred and five out of one hundred and thirty two (79.5%) patients were safely delabeled. These findings confirm the safety and effectiveness of PAD programs in outpatient settings and highlight the potential for improving antibiotic stewardship by reducing unnecessary beta-lactam avoidance.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
131
审稿时长
6-12 weeks
期刊介绍: Founded in 1972 by Professor A. Oehling, Allergologia et Immunopathologia is a forum for those working in the field of pediatric asthma, allergy and immunology. Manuscripts related to clinical, epidemiological and experimental allergy and immunopathology related to childhood will be considered for publication. Allergologia et Immunopathologia is the official journal of the Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) and also of the Latin American Society of Immunodeficiencies (LASID). It has and independent international Editorial Committee which submits received papers for peer-reviewing by international experts. The journal accepts original and review articles from all over the world, together with consensus statements from the aforementioned societies. Occasionally, the opinion of an expert on a burning topic is published in the "Point of View" section. Letters to the Editor on previously published papers are welcomed. Allergologia et Immunopathologia publishes 6 issues per year and is included in the major databases such as Pubmed, Scopus, Web of Knowledge, etc.
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