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Performance in real life of the European Network on Drug Allergy algorithm in immediate reactions to beta‐lactam antibiotics
Author(s) -
Moreno E.,
Laffond E.,
MuñozBellido F.,
Gracia M. T.,
Macías E.,
Moreno A.,
Dávila I.
Publication year - 2016
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.13032
Subject(s) - medicine , drug allergy , anaphylaxis , provocation test , allergy , antibiotics , drug , beta lactam , algorithm , gastroenterology , immunology , pharmacology , pathology , alternative medicine , computer science , microbiology and biotechnology , biology
European Network on Drug Allergy ( ENDA ) has proposed an algorithm for diagnosing immediate beta‐lactam ( BL ) allergy. We evaluated its performance in real life. During 1994–2014, 1779 patients with suspected immediate reactions to BL were evaluated following ENDA 's short diagnostic algorithm. Five hundred and nine patients (28.6%) were diagnosed of BL hypersensitivity. Of them, 457 (25.7%) were at first evaluation [403 by skin tests ( ST ), 12 by positive IgE and 42 by controlled provocation tests ( CPT )]. At second evaluation ( SE ), 52 additional patients (10.2% of allergic patients) were diagnosed, [50 (2.8%) by ST and 2 (0.1%) by CPT ]. Time between reaction and study was significantly longer in patients diagnosed at SE (median 5 vs 42 months; IQR 34 vs 170; P < 0.0001). Anaphylaxis was significantly associated with a diagnosis at SE . European Network on Drug Allergy/ EAACI protocol was appropriate and safe when evaluating BL immediate reactions. Re‐evaluation should be performed, particularly when anaphylaxis and long interval to diagnosis are present.