RESUMEN
OBJECTIVES: Antibiotic allergy labels (AAL) are related to worse therapeutic results. Strategies to improve the management of these patients, such as the implementation of antibiotic desensitization, are essential for Antimicrobial Stewardship Programs (ASP). The aim of our study is to evaluate the efficacy and safety of antibiotic desensitization procedures for the management of patients with AAL. METHODS: A retrospective study from 2015 to 2022 was performed to describe all antibiotic desensitization conducted in our institution, within the framework of ASP. A systematic literature review using electronic databases, such as PubMed, was also done to identify studies describing antibiotic desensitization between 2000 and 2022. RESULTS: Sixteen antibiotic desensitization protocols were carried out in our institution. In fourteen cases, the desensitization was successfully completed, and the antibiotic could be used to treat the infection. In the systematic review, twenty-two studies were included, with a total of 202 desensitization episodes . In 97% of them, the desensitization was completed successfully. No desensitization-related mortality was observed neither in our cohort nor in literature review. CONCLUSIONS: Antibiotic desensitization strategies should be considered a safe and effective tool that can be included in ASP for patients with a high risk of or confirmed allergy to penicillin.
Asunto(s)
Programas de Optimización del Uso de los Antimicrobianos , Hipersensibilidad a las Drogas , Humanos , Antibacterianos/efectos adversos , Estudios Retrospectivos , Análisis de Datos , Penicilinas/efectos adversos , Hipersensibilidad a las Drogas/terapiaRESUMEN
La exposición prenatal al alcohol es la principal causa prevenible del déficit cognitivo en los países desarrollados y puede dar lugar al trastorno del espectro alcohólico fetal (TEAF). Este término engloba una gran variedad de efectos físicos, mentales, conductuales y cognitivos que derivan del daño causado por la exposición al alcohol durante la vida intrauterina. El consumo de esta sustancia entre la población general es frecuente en los países de la Europa del Este y, especialmente, entre las mujeres en riesgo de exclusión social, que son las mayores afectadas en procesos de pérdida o renuncia de custodia de sus hijos. Un elevado número de estos niños son adoptados en España y muchos de ellos presentan alteraciones neurocognitivas y conductuales, convirtiendo el TEAF en un problema de salud pública en nuestro país. En muchas ocasiones, este cuadro clínico está infradiagnosticado debido a la superposición de los síntomas neuropsicológicos causados por el abandono y la falta de apego. Hasta el momento, no se ha descrito un perfil neurocognitivo y conductual específico del TEAF y muchos de los síntomas son comunes a otras etiologías. El objetivo de este trabajo es revisar el perfil neuropsicológico en el diagnóstico de TEAF. (AU)
Prenatal alcohol exposure is the leading preventable cause of cognitive deficit in developed countries and can lead to fetal alcohol spectrum disorder (FASD). This term encompasses a wide range of physical, mental, behavioral, and cognitive effects that result from damage caused by exposure to alcohol during intrauterine life. Alcohol consumption among the general population is common in Eastern European countries and especially among women at risk of social exclusion, who are the ones who lose or give up custody of their children. A high number of these children are adopted in Spain and many of them present neurocognitive and behavioral disorders, causing FASD to be a public health problem in our country. In many occasions this clinical spectrum is delayed or under-diagnosed due to the overlapping of neuropsychological symptoms caused by the abandonment. A neurocognitive and behavioral profile specific for FASD has not been defined and all the symptoms are common to other etiologies. The aim of this work is to review the neuropsychological profile in the diagnosis of TEAF. (AU)
Asunto(s)
Humanos , Embarazo , Trastornos del Espectro Alcohólico Fetal/fisiopatología , Trastornos del Espectro Alcohólico Fetal/psicología , Trastorno por Déficit de Atención con Hiperactividad , Trastornos Neurocognitivos , Marginación Social , Niño AdoptadoRESUMEN
Prenatal alcohol exposure is the leading preventable cause of cognitive deficit in developed countries and can lead to fetal alcohol spectrum disorder (FASD). This term encompasses a wide range of physical, mental, behavioral, and cognitive effects that result from damage caused by exposure to alcohol during intrauterine life. Alcohol consumption among the general population is common in Eastern European countries and especially among women at risk of social exclusion, who are the ones who lose or give up custody of their children. A high number of these children are adopted in Spain and many of them present neurocognitive and behavioral disorders, causing FASD to be a public health problem in our country. In many occasions this clinical spectrum is delayed or under-diagnosed due to the overlapping of neuropsychological symptoms caused by the abandonment. A neurocognitive and behavioral profile specific for FASD has not been defined and all the symptoms are common to other etiologies. The aim of this work is to review the neuropsychological profile in the diagnosis of FASD.
