دورية أكاديمية
Deconstructing Adverse Reactions to Amoxicillin- Clavulanic Acid: The Importance of Time of Onset.
| العنوان: | Deconstructing Adverse Reactions to Amoxicillin- Clavulanic Acid: The Importance of Time of Onset. |
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| المؤلفون: | Freundt-Serpa NP; Allergy Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos -IdISSC, Madrid, Spain.; Allergy Research Group, IdISSC, Madrid, Spain., Salas-Cassinello M; Allergy Unit, Hospital Regional Universitario de Málaga, Málaga, Spain.; Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain., Gonzalo-Fernández A; Allergy Research Group, IdISSC, Madrid, Spain., Marchán-Pinedo N; Allergy Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos -IdISSC, Madrid, Spain.; Allergy Research Group, IdISSC, Madrid, Spain., Doña I; Allergy Unit, Hospital Regional Universitario de Málaga, Málaga, Spain.; Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain., Serrano-García I; Unidad de Apoyo Metodológico a la Investigación (UAMI), IdISSC, Madrid, Spain., Humanes-Navarro AM; Preventive Medicine and Public Health Department, Hospital Clínico San Carlos, IdISSC, Madrid, Spain., Bogas G; Allergy Unit, Hospital Regional Universitario de Málaga, Málaga, Spain.; Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain., Labella M; Allergy Unit, Hospital Regional Universitario de Málaga, Málaga, Spain.; Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain., Sánchez-Morillas L; Allergy Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos -IdISSC, Madrid, Spain.; Allergy Research Group, IdISSC, Madrid, Spain., Torres MJ; Allergy Unit, Hospital Regional Universitario de Málaga, Málaga, Spain.; Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.; Nanostructures for Diagnosing and Treatment of Allergic Diseases Laboratory, Andalusian Center for Nanomedicine and Biotechnology- BIONAND, Málaga, Spain.; Departamento de Medicina, Universidad de Málaga, Málaga, Spain., Fernández-Rivas M; Allergy Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos -IdISSC, Madrid, Spain.; Allergy Research Group, IdISSC, Madrid, Spain.; Facultad de Medicina, Universidad Complutense de Madrid, Málaga, Spain. |
| المصدر: | Journal of investigational allergology & clinical immunology [J Investig Allergol Clin Immunol] 2024 Jun 17; Vol. 34 (3), pp. 177-187. Date of Electronic Publication: 2023 Feb 23. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Esmon Publicidad Country of Publication: Spain NLM ID: 9107858 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1018-9068 (Print) Linking ISSN: 10189068 NLM ISO Abbreviation: J Investig Allergol Clin Immunol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2004- : Barcelona, Spain : Esmon Publicidad Original Publication: Barcelona, Spain : J.R. Prous, S.A., c1991- |
| مواضيع طبية MeSH: | Drug Hypersensitivity*/diagnosis , Drug Hypersensitivity*/epidemiology , Drug Hypersensitivity*/etiology , Amoxicillin-Potassium Clavulanate Combination*/adverse effects , Amoxicillin-Potassium Clavulanate Combination*/immunology, Humans ; Female ; Male ; Middle Aged ; Cross-Sectional Studies ; Retrospective Studies ; Adult ; Aged ; Anti-Bacterial Agents/adverse effects ; Anti-Bacterial Agents/immunology ; Spain/epidemiology ; Time Factors ; Hypersensitivity, Immediate/diagnosis ; Hypersensitivity, Immediate/epidemiology ; Hypersensitivity, Delayed/diagnosis |
| مستخلص: | Background and Objective: Amoxicillin-clavulanic acid (AX-CL) is the most consumed ß-lactam antibiotic worldwide. We aimed to establish the different phenotypes of ß-lactam allergy in patients reporting a reaction to AX-CL and to investigate the differences between immediate and nonimmediate onset. Methods: We performed a cross-sectional retrospective study at Hospital Clínico San Carlos (HCSC), Madrid and Hospital Regional Universitario de Málaga (HRUM), Málaga, Spain. We included patients reporting reactions with AX-CL who underwent the allergy workup between 2017 and 2019. Data on the reported reaction and allergy work-up were collected. Reactions were classified as immediate and nonimmediate with a 1-hour cut-off. Results: The study population comprised 372 patients (HCSC 208, HRUM 164). There were 90 immediate reactions (24.2%), 252 nonimmediate reactions (67.7%), and 30 reactions with unknown latency (8.1%). Allergy to ß-lactams was ruled out in 266 patients (71.5%) and confirmed in 106 patients (28.5%). The final main diagnosis in the overall population was allergy to aminopenicillins (7.3%), to CL (7%), to penicillin (6.5%), and to ß-lactams (5.9%). Allergy was confirmed in 77.2% and 14.3% of immediate and nonimmediate reactions, respectively, with a relative risk of 5.06 (95%CI, 3.64-7.02) for an allergy diagnosis in those reporting immediate reactions. Only 2/54 patients with a late-positive intradermal test (IDT) result for CL were diagnosed with CL allergy. Conclusion: Allergy was diagnosed in a minority of the study population. However, given that it was diagnosed 5 times more frequently in patients reporting immediate reactions, this classification proved useful for risk stratification. Late-positive IDT results for CL have no diagnostic value. Therefore, the late IDT reading for CL could be removed from the diagnostic work-up. |
| فهرسة مساهمة: | Keywords: Amoxicillin-clavulanic acid; Drug allergy; Immediate reaction; Intradermal test; Nonimmediate reaction |
| المشرفين على المادة: | 74469-00-4 (Amoxicillin-Potassium Clavulanate Combination) 0 (Anti-Bacterial Agents) |
| تواريخ الأحداث: | Date Created: 20230222 Date Completed: 20240618 Latest Revision: 20240618 |
| رمز التحديث: | 20240619 |
| DOI: | 10.18176/jiaci.0896 |
| PMID: | 36811840 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1018-9068 |
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| DOI: | 10.18176/jiaci.0896 |