我们离消除青霉素/ß-内酰胺过敏警报误报还有多远?人口问题。

IF 6.1 3区 医学 Q1 ALLERGY Journal of Investigational Allergology and Clinical Immunology Pub Date : 2025-02-18 Epub Date: 2024-05-09 DOI:10.18176/jiaci.1004
M A Tejedor-Alonso, M Perez-Encinas, S Sanz Márquez, J J Martinez Simon, L Moreno-Nuñez, A Gonzalez-Moreno, J Macias-Iglesias, A Rosado-Ingelmo
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引用次数: 0

摘要

背景:由于人们意识到青霉素过敏标签患者的假阴性诊断率相当高(90%-95%)、使用非ß-内酰胺类抗生素的疗效较差、细菌耐药性增加,以及在某些国家这些问题可能会影响多达 20% 的人口,因此人们对寻找消除青霉素过敏警报的有效方法越来越感兴趣。在开展此类研究的过敏学家人数较少的国家,所提出的策略已发表了许多论文。在很多情况下,ß-内酰胺类药物过敏的风险很低,一次青霉素挑战就足以解除警报。然而,也可以采用其他不那么 "超快速 "的策略,在入院治疗感染期间使用ß-内酰胺类药物,从而将解除标签的时间推迟到传统的药物过敏会诊之后。然而,ß-内酰胺类药物警报的最终撤消受到电子健康记录中警报未撤消以及不同级别医疗机构电子系统之间警报重新激活或不同步的威胁。过敏科需要反思如何快速有效地解除药物过敏警报,尤其是对有重大并发症的患者。
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How Far Are We From Achieving Delabeling of False Penicillin/ß-Lactam Allergy Alerts? A Population Problem.

Interest in finding efficient ways to remove penicillin allergy alerts has grown as a result of awareness of the considerable excess of falsenegative diagnoses in patients with penicillin allergy labels (90%-95%), the poorer course with non-ß-lactam antibiotics, the increase in bacterial resistance, and the fact that these problems can affect up to 20% of the population in some countries. The strategies proposed have generated many publications in countries where the number of allergists to conduct such studies is low. In many cases where delabeling is performed, the risk of ß-lactam allergy is low, and a single penicillin challenge is sufficient to delabel the alert. However, other less "ultrarapid" strategies can be used to administer a ß-lactam during an admission for infection and thus postpone delabeling until traditional drug allergy consultations. However, the definitive withdrawal of ß-lactam alerts is threatened by nonremoval of alerts in electronic health records and by the reactivation or nonsynchronization of alerts between electronic systems at different levels of care. Allergy departments need to reflect on how to implement practices that enable rapid and efficient delabeling of drug allergy alerts, especially in patients with major comorbidities.

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来源期刊
CiteScore
7.10
自引率
9.70%
发文量
135
审稿时长
6-12 weeks
期刊介绍: The Journal of Investigational Allergology and Clinical Immunology (J Investig Allergol Clin Immunol) provides an attractive and very active forum for basic and clinical research in allergology and clinical immunology.Journal of Investigational Allergology and Clinical Immunology publishes original works, reviews, short communications and opinions.
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