Eficiencia del estudio alergológico en el diagnóstico de reacciones a beta-lactámicos / Efficiency of the allergological study in the diagnosis of allergic reactions to beta-lactams

Objetivos Valorar qué proporción de pacientes etiquetados como alérgicos β-lactámicos siguen teniendo dicha etiqueta en su historial médico tras realizarles un estudio alergológico, a qué proporción de los no alérgicos se les volvió a recetar uno de estos antibióticos y si el estudio alergológico es rentable. Métodos Est udio retrospectivo entre 2019 y 2021 en el que valoramos los pacientes por sospecha de alergia a β-lactámicos (n=688). A través del estudio alergológico se aclaró si tenían dicha alergia. Posteriormente, se revisó si continuaba constando la etiqueta de alérgico en el historial médico. A través de la prescripción digital en la tarjeta sanitaria se ha observado si se les volvió a recetar dicho antibiótico tras el estudio y si lo retiraron de la farmacia. Resultados Un 11,3% de pacientes presentaban hipersensibilidad a β-lactámicos. Sin embargo, en un 33,1% de pacientes continuaban presentando la etiqueta de alérgicos en su historial médico a pesar de no serlo. En un 32% de pacientes en los que se había confirmado la alergia tenían la etiqueta de alérgicos en su historial sin revisar por su médico de atención primaria y en un 32,8% se les había recetado de nuevo un β-lactámico. Conclusiones Es igual de importante descartar la alergia a dichos antibióticos como modificar la etiqueta de alérgico en su historial médico tras el estudio. Una proporción de no alérgicos siguen constando como alérgicos tras el estudio. Estar etiquetado como alérgicos a los β-lactámicos tiene consecuencias a corto y largo plazo tanto para el propio paciente como para el gasto sanitario. (AU)

Aims Assessing the rate of β-lactams-allergic patients who are still labelled as such in their medical records after being performed an allergic test; as well as the rate of no allergic patients who were prescribed one of these antibiotics; and pondering whether the allergic test is hence cost-effective. Methods This is a retrospective study developed from 2019 to 2021 focusing on patients suspected of β-lactams allergy (n=688). By means of an allergy test, it was cleared out if they were actually allergic. Later, we checked if the patient was still labelled as allergic in their medical record. Tracking through the digital health services card, we followed up if the antibiotic was ever prescribed again, and if the drug was then dispensed to the patient. Results 11.3% of the patients showed hypersensitivity to β-lactams. Nonetheless, 33.1% of the patients were still considered allergic to these antibiotics in their medical record even though not being such. 32% of the patients – who had their allergy confirmed – had been labelled without the general practitioner's acknowledgment, and 32.8% had even been prescribed a β-lactam again. Conclusions Discarding any allergy to β-lactams is as important as registering the allergy on medical records after testing the patient. A remarkable quantity of non-allergic patients is still addressed as actual allergic, in spite not being such. Labelling patients as β-lactams allergic may have consequences, short-term and long-term, for the patient but also for the health service budget. (AU)

[Efficiency of the allergological study in the diagnosis of allergic reactions to beta-lactams]. / Eficiencia del estudio alergológico en el diagnóstico de reacciones a ß-lactámicos.

AIMS: Assessing the rate of ß-lactams-allergic patients who are still labelled as such in their medical records after being performed an allergic test; as well as the rate of no allergic patients who were prescribed one of these antibiotics; and pondering whether the allergic test is hence cost-effective. METHODS: This is a retrospective study developed from 2019 to 2021 focusing on patients suspected of ß-lactams allergy (n=688). By means of an allergy test, it was cleared out if they were actually allergic. Later, we checked if the patient was still labelled as allergic in their medical record. Tracking through the digital health services card, we followed up if the antibiotic was ever prescribed again, and if the drug was then dispensed to the patient. RESULTS: 11.3% of the patients showed hypersensitivity to ß-lactams. Nonetheless, 33.1% of the patients were still considered allergic to these antibiotics in their medical record even though not being such. 32% of the patients - who had their allergy confirmed - had been labelled without the general practitioner's acknowledgment, and 32.8% had even been prescribed a ß-lactam again. CONCLUSIONS: Discarding any allergy to ß-lactams is as important as registering the allergy on medical records after testing the patient. A remarkable quantity of non-allergic patients is still addressed as actual allergic, in spite not being such. Labelling patients as ß-lactams allergic may have consequences, short-term and long-term, for the patient but also for the health service budget.