Effects of Sex and Gender in Immediate Beta-Lactam Antibiotic Allergy: A Systematic Review and Meta-analysis.

IF 8.2 1区医学 Q1 ALLERGY Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2024-11-02 DOI:10.1016/j.jaip.2024.10.031

Nisha B Patel, Gabriel Cojuc-Konigsberg, Danna Garcia-Guaqueta, Divya Shah, Darshana Balasubramaniam, Avanika Mahajan, Fnu Shakuntulla, Danielle Gerberi, Lyda Cuervo-Pardo, Miguel A Park, Thanai Pongdee, Elina Jerschow, Avni Joshi, Zhen Wang, Alexei Gonzalez-Estrada, Sergio E Chiarella

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Abstract

Background: Beta-lactams are the most common antibiotic class reported to cause allergic drug reactions. Previous literature suggests an increased prevalence of penicillin drug allergy in female patients in both inpatient and outpatient settings. However, the effects of sex and gender have not been well characterized regarding the entire class of beta-lactam antibiotics.

Objective: This systematic review and meta-analysis aimed to identify sex and gender-based differences in the prevalence of immediate beta-lactam allergy.

Methods: We performed an electronic search of Ovid MEDLINE/PubMed, Embase, Web of Science, Scopus, and the Cochrane Library between 2013-2023. Patients with a documented beta-lactam allergy who underwent allergy testing with skin testing, oral drug challenge, or serum-specific IgE were included. We quantitatively assessed sex- and gender-based differences in beta-lactam allergy with meta-analysis.

Results: We included 69 primary studies, assessing 53,989 participants from outpatient and inpatient cohorts. 7,558 patients had a confirmed beta-lactam allergy. There was no difference in the prevalence of positive beta-lactam allergy test between males and females. Sub-group analysis of studies that performed oral challenges did show a higher risk of beta-lactam allergy in females than males (RR 1.40, 95% CI 1.18-1.66, p < 0.001, I² =77.8%). Finally, there was a higher proportion of females (64.8%) than males enrolled in beta-lactam allergy studies.

Conclusions: Our findings suggest both sex-based and gender-based differences in the prevalence of immediate beta-lactam allergy. Both biological factors, such as sex hormones, and gender-based behaviors, including increased healthcare utilization, may contribute to higher rates of beta-lactam allergy diagnosis in females.

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Beta-内酰胺类抗生素即刻过敏的性别影响：系统回顾与元分析》。

背景：据报道，β-内酰胺类是引起药物过敏反应最常见的抗生素类别。以往的文献表明，无论是住院病人还是门诊病人，青霉素药物过敏在女性病人中的发生率都有所增加。然而，在整个β-内酰胺类抗生素中，性别的影响还没有得到很好的描述：本系统综述和荟萃分析旨在确定即时β-内酰胺类抗生素过敏发生率的性别差异：我们对 2013-2023 年间的 Ovid MEDLINE/PubMed、Embase、Web of Science、Scopus 和 Cochrane 图书馆进行了电子检索。研究纳入了通过皮肤测试、口服药物挑战或血清特异性 IgE 进行过敏测试的β-内酰胺过敏患者。我们通过荟萃分析对β-内酰胺过敏的性别差异进行了定量评估：我们纳入了 69 项主要研究，评估了 53989 名门诊和住院患者。7558名患者确诊对β-内酰胺类药物过敏。男性和女性的β-内酰胺类药物过敏试验阳性率没有差异。对进行口服测试的研究进行的分组分析表明，女性比男性患β-内酰胺类药物过敏的风险更高（RR 1.40，95% CI 1.18-1.66，p < 0.001，I2 =77.8%）。最后，参与β-内酰胺过敏研究的女性比例（64.8%）高于男性：我们的研究结果表明，β-内酰胺类药物过敏的发生率既有性别差异，也有生理差异。生物因素（如性激素）和基于性别的行为（包括更多使用医疗保健服务）都可能导致女性的 beta 内酰胺过敏诊断率更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.

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