Prevalence and characteristics of reported penicillin allergy in an urban outpatient adult population
Prevalence and characteristics of reported penicillin allergy in an urban outpatient adult population
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DOI：
10.2500/aap.2014.35.3791
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发表时间：
2014-11-01
影响因子：
2.8
通讯作者：
Agarwal, Shradha
中科院分区：
文献类型：
--
作者：
Albin, Stephanie;Agarwal, Shradha
青霉素过敏仍然是最常见的药物过敏，据报道在美国的患病率为10%。门诊人群中青霉素过敏的流行病学研究相对较少。本研究旨在明确城市门诊人群中青霉素过敏的患病率和特征，并从服务于大城市中心人群的三级医疗中心中确定临床评价和管理中的三种类型。对2012年1月31日至2012年7月31日期间在西奈山医院内科联合诊所就诊的成人患者的电子病历进行了回顾性审查。根据患者过敏章节中的青霉素记录选择病历。在门诊就诊的11，761例患者中，1348例患者（11.5%）报告了青霉素过敏史。最常见的过敏反应为皮疹（37%）、未知/未记录（20.2%）、荨麻疹（18.9%）、肿胀/血管性水肿（11.8%）和速发过敏反应（6.8%）。女性患者与男性患者的接触中青霉素过敏的患病率增加（比值比[OR] = 1.82; 95%CI = 1.60，2.08; p < 0.0001），与白人相比，亚洲人青霉素过敏的发生率显著更低（OR = 0.51; 95% CI = 0.32，0.83; p = 0.007）：然而，仅78例（6%）报告青霉素过敏的患者转诊至过敏专科医生。总的来说，改善转诊到过敏症专科医生将有助于确定患者谁有青霉素过敏需要避免。
Penicillin allergy remains the most common drug allergy, with a reported prevalence of 10% in the,United States. Epidemiology of penicillin allergy in outpatient populations is relatively scarce. This study sought to clete.rmine',the prevalence and characteristics of reported penicillin allergy in an urban outpatient population and to identify trerids in clinical evaluation and management from a tertiary center serving a large inner-city population. A retrospective review of electronic medical records was performed of adult patients seen in the Internal Medicine Associates Clinic of Mount Sinai Hospital between January 31, 2012, and July 31, 2012. Medical records were selected based on the documentation of penicillin in patient's allergy section. Of the 11,761 patients seen in the clinic, 1348 patients (11.5%) reported A history of penicillin allergy. The most common allergic reactions were rash (37%), unknown/undocumented (20.2%), hives (18.9%), swelling/angioedema (11.8%), and anaphylaxis (6.8%). There was an increased prevalence of penicillin allergy in female pathmts'conipared with male patients (odds ratio [OR] = 1.82; 95% CI = 1.60, 2.08; p < 0.0001), and there were significantly fewer Asians with penicillin allergy compared with Caucasians (OR = 0.51; 95% CI = 0.32, 0.83; p = 0.007): However, only 78 (6%) of the patients reporting penicillin allergy had a referral to an allergy specialist. Overall, improved referral to an allergist will help to identify patients who have penicillin allergy requiring avoidance.