3048 Investigation into patients with suspected adverse reactions to beta-lactams carried out by the allergy unit of rio de janeiro general policlinic

Tuesday, 9 December 2014
Exhibition Hall-Poster Area (Sul America)

Flavia Carvalho Loyola Loyola, MD , Policlinica Geral Do Rio De Janeiro, Rio de Janeiro, Brazil

Tania Tavares Gonçalves, MD

Luiz Carlos Arcanjo, MD , WAO Junior Member, Rio de Janeiro, Brazil

João Bosco Magalhães Rios

Marcelo Lobo Silva

Eduardo Ramos Guimarães

Terezinha Branchi Pereira Piscitelli

Emmanuel Reis Martins

Background:

Due to the high prevalence of patients with suspected adverse reaction (AR) to Beta lactam (BL), this study aims to determine the incidence of hypersensitivity reactions to these drugs, based on ENDA protocol (European Network for Drug Allergy).

Methods:

This study was a retrospective analysis of cases of patients referred to the Allergy Clinic of Rio de Janeiro General Policlinic with records of suggestive of AR  to BL, in the period between February 2011 and July 2014.  All the patients observed  ENDA protocol: specific questionnaire of adverse drug reactions, IgE specific for penicillin G and V, amoxicillin and ampicillin, followed by skin prick tests (SPT) and intradermal (ID) with penicillin and amoxicillin. Finally, the provocation test (DTP) was carried out with Amoxicillin, each step being followed from the previous negative result. 

Results:

Forty seven tests were performed, in 35 women (74.4%) with predominant age group between 50 and 70 years (36% of the women) and 12 men (25.5%) without predominant age range from 6 to 62 years old. There were 10 positive tests (21.7%) with 3 positive tests in making the SPT, 5 in ID test with non-immediate reaction and 3 in DTP also with non- immediate reaction. Eighty percent of patients with positive results were women aged between 15 and 62 years (75% over 40 years) and only two male patients aged between 11 and 25 years.

Conclusions:

These results demonstrated the importance of confirming a suspected history of AR to BL through specific tests, since 21.2% of patients have proved to have drug allergy, in contrast with 10% of the international literature. And the negative provocation tests are important because they allow the patient to use the drug tested in the future.