5PSQ-030\u2005Do we know which antibiotics should be avoided in our patients? Antibiotic allergy survey among hospitalised patients

Abstract

Background It is known from allergy databases that antibacterials belong to the common sensitising drugs. However, antibacterials are frequently administered in the hospital setting both for prophylactic and for therapeutic purposes. Considering drug allergy is an important drug safety issue, but inadequate allergy labelling can negatively affect drug choice. Purpose To assess the prevalance and characteristics of antibiotic allergy and to differentiate cases where the allergic nature of drug raction can be excluded/or has weak grounding. Material and methods A structured interview guide was used for the face-to-face anonymous interviews with hospitalised adult inpatients. Results During the 19 study days, among the 1522 hospitalised patients 114 mentioned allergy to systemic antibiotics (7.5%). Most of the patients were allergic to one active agent, (100 patients), while 14 patients were polysensitised (allergic to two or more antibacterials). In the majority of cases (81 cases) penicillin products caused the drug reaction, and second, sulfonamides (18 cases) were mentioned. In 24 cases, the patient did not have any information on signs/symptoms of the drug reaction and in 14 cases drug allergy can be excluded (e.g. diarrhoea as the only reaction). Most often drug reactions occured in the hospital setting (30 cases), if not, in 12 cases hospital admission was necessary due to severity. Antibacterials most often resulted in cutaneous reactions (71 cases). Skin reaction/pruritus was the only sign in 48 cases and in 15 cases this reaction happened in childhood. Severe cutaneous drug reaction – EEM and SJ syndrome occured in seven cases. Unintended drug re-exposure occured in eight cases, resulting in reactions similar to the earlier ones (in two cases with severe life-threatening anaphylaxis). Only 12 patients (10.5%) had an allergy ‘passport’. Conclusion Antibiotic allergy was prevalent among the interviewed inpatients. In some of these reactions allergic nature can be excluded by the anamnesis, while other cases had weak evidence due to the complete lack of the anamnesis/childhood occurence of skin reactions. Only very few patients had an allergy passport. Hospital pharmacists can exclude untrue allergic reactions during the reconciliation process and can help in the proper documentation of drug allergy. References and/or acknowledgements We sincerely thank all the participating patients. No conflict of interest.