Beta-lactam allergy was a prevalent problem in regular medical practice and was recognized as a significant public health concern. For a study, researchers looked back at the clinical records of 576 patients referred to the institution with a beta-lactam antibiotic allergy label and were carefully assessed using a standardized procedure. Investigators sought to determine the frequency of verified immediate- and delayed-type allergy to regularly given beta-lactam antibiotic subclasses (penicillin and cephalosporin) and the negative predictive value (NPV) and sensitivity of skin tests. The safety of beta-lactam skin testing and drug challenge was the secondary goals. The study group discovered that 260 patients had experienced instantaneous reactions, 131 had experienced delayed reactions, and 114 had experienced reactions with uncertain timing or mechanism. Following evaluation and testing, 86 (18.3%) patients exhibited a verified allergy to any beta-lactam antibiotic, with 63 (13.4%) having an immediate reaction and 23 (4.9%) having a delayed reaction. Penicillins were the most frequently identified verified allergy (65 individuals), followed by cephalosporins (21 patients). When immediate-type reactions were investigated, the NPV of skin tests was 96.3% for penicillins and 100% for cephalosporins, respectively. When delayed reactions were considered, the NPV for penicillins and cephalosporins were 91.9% and 87.5%, respectively. Systemic allergic reactions occurred in only 0.7% of skin tests and 3.1% of drug challenges, according to a standardized technique for evaluating the safety of skin tests. The results indicate that only 18.3% of patients with a beta-lactam allergy label had a verified allergy and that non-allergic patients could be safely delabeled using skin testing and drug challenges. The strategy supports the policy of sparing second-line antibiotics through a uniform allergy workup.
Source:www.frontiersin.org/articles/10.3389/falgy.2022.853587/full
