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Risk factors of beta-lactam anaphylaxis in Korea: A 6-year multicenter retrospective adult case-control study

Authors
 Chan Sun Park  ;  Min-Suk Yang  ;  Dong-Yoon Kang  ;  Hye Jung Park  ;  So-Young Park  ;  Young-Hee Nam  ;  Sujeong Kim  ;  Jae-Woo Jung  ;  Hye-Kyung Park  ;  Hye-Ryun Kang 
Citation
 WORLD ALLERGY ORGANIZATION JOURNAL, Vol.14(9) : 100580, 2021-08 
Journal Title
WORLD ALLERGY ORGANIZATION JOURNAL
ISSN
 * 
Issue Date
2021-08
Keywords
Anaphylaxis ; Angiotensin-converting enzyme inhibitors ; Beta-lactams ; Case-control studies ; Cephalosporin ; Drug hypersensitivity
Abstract
Background: Beta-lactams (BLs) are commonly used antibiotics and leading causative agents of drug-induced anaphylaxis. Few studies on the culprit drugs and risk factors of BL-induced anaphylaxis are available. Our goal was to evaluate the culprit drugs and compare the risk factors in patients with BL-induced anaphylaxis to matched tolerant controls in a hospital setting.

Methods: We retrospectively enrolled all patients who developed anaphylaxis from intravenous BL during hospitalization from 9 Korean hospitals. We compared clinical parameters between patients with BL-induced anaphylaxis and 4-fold BL-tolerant controls matched by age, sex, BL use, and the purpose of BL administration.

Results: Seventy-four cases of BL-induced anaphylaxis and 296 BL-tolerant controls were enrolled. Cephalosporin accounted for 77% of total BL-induced anaphylaxis, and the top derivatives were ceftriaxone (23.0%), cefazedone (10.8%), and cefbuperazone (9.5%). Among penicillin derivatives, piperacillin (16.2%) was the most common, followed by ampicillin (2.7%). History of drug allergy (odds ratio [OR], 19.91; 95% confidence interval [CI] 5.33-74.44), previous exposure to the causative BL (OR, 7.71; 95% CI, 1.62-36.76), and concurrent administration of angiotensin-converting enzyme inhibitors (ACEIs) (OR, 5.97; 95% CI, 1.28-27.91) were independent risk factors associated with BL-induced anaphylaxis. Food allergy (OR, 13.93; 95% CI 1.31-148.9) and previous exposure to BL (OR, 6.59; 95% CI, 1.30-33.31) were identified as risk factors for cephalosporin-induced anaphylaxis.

Conclusions: To prevent BL-induced anaphylaxis, attention should be paid to histories of drug or food allergy, previous exposure to BLs, and ACEI use. The risk factors and clinical outcomes might vary according to the BL classes.
Full Text
https://www.sciencedirect.com/science/article/pii/S1939455121000740
DOI
10.1016/j.waojou.2021.100580
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Hye Jung(박혜정) ORCID logo https://orcid.org/0000-0002-1862-1003
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190763
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