Diagnosis of allergy against beta-lactams in primary care: prevalence and diagnostic criteria.
Background: Secondary care studies showed that a recorded allergy to beta-lactams could not be confirmed by valid allergy testing in >85% of cases. In daily practice, recorded beta-lactam allergies probably cause prescription of secondary choice antibiotics. This overrating of beta-lactam allergy ha...
| Publicado en: | Family Practice Vol. 32; no. 3; pp. 257 - 263 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
Oxford University Press / USA
Jun2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109739916&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109739916 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02632136 F9X jtl: Family Practice issn: 02632136 maglogo: N pubinfo: dt: Jun2015 vid: 32 iid: 3 pid: 622 pub: Oxford University Press / USA artinfo: ui: 109739916 NLM25851993 2013022899 10.1093/fampra/cmv018 NLM25851993 109739916 ppf: 257 ppct: 6 formats: tig: atl: Diagnosis of allergy against beta-lactams in primary care: prevalence and diagnostic criteria. aug: au: Salden, Odette A E Rockmann, Heike Verheij, Theo J M Broekhuizen, Berna D L sug: ab: Background: Secondary care studies showed that a recorded allergy to beta-lactams could not be confirmed by valid allergy testing in >85% of cases. In daily practice, recorded beta-lactam allergies probably cause prescription of secondary choice antibiotics. This overrating of beta-lactam allergy hampers appropriate use of narrow spectrum antibiotic and generates unnecessary cost and bacterial resistance.Objective: To assess registration and over diagnosis of allergies against beta-lactams in Dutch primary care.Methods: A retrospective cohort study in 8288 primary care subjects was performed. Patients with recorded allergy were identified through International Classification for Primary Care coding. Signs and symptoms of the recorded allergic reaction and patient's characteristics were extracted from patient's files and patients were sent a questionnaire. The probability of allergy was based on a composite reference standard that was scored by two authors independently.Results: One hundred sixty-three subjects had a recorded allergy (2.0%). In 51.5% of cases, no characteristics of the recorded allergic reaction were reported in patients' medical files. Based on our composite reference standard, allergy was excluded in 19 subjects (11.7%). Risk factors for allergy registration were female gender, age <4 years, and the comorbidities-asthma, allergies and skin disorders.Conclusions: The prevalence of recorded allergy against beta-lactam antibiotics in a large Dutch primary care centre was 2%. Due to lack of registration of accompanying signs and symptoms of the recorded allergy, this diagnosis is uncertain in most patients. Better documentation and classification by a screening algorithm of future possible allergic reactions to beta-lactams are needed in primary care. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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