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Analysis of profitability in the diagnosis of allergy to beta-lactam antibiotics.
Ferré-Ybarz, L; Salinas Argente, R; Gómez Galán, C; Duocastella Selvas, P; Nevot Falcó, S.
Afiliación
  • Ferré-Ybarz L; Allergy Service, Althaia, Xarxa Assistencial i Universitària de Manresa, Hospital Sant Joan de Déu, Manresa, Barcelona, Spain. Electronic address: lferre@althaia.cat.
  • Salinas Argente R; Banc de Sang i Teixits Catalunya Central i Vallès Occidental, Spain.
  • Gómez Galán C; Allergy Service, Althaia, Xarxa Assistencial i Universitària de Manresa, Hospital Sant Joan de Déu, Manresa, Barcelona, Spain.
  • Duocastella Selvas P; Allergy Service, Althaia, Xarxa Assistencial i Universitària de Manresa, Hospital Sant Joan de Déu, Manresa, Barcelona, Spain.
  • Nevot Falcó S; Allergy Service, Althaia, Xarxa Assistencial i Universitària de Manresa, Hospital Sant Joan de Déu, Manresa, Barcelona, Spain.
Allergol Immunopathol (Madr) ; 43(4): 369-75, 2015.
Article en En | MEDLINE | ID: mdl-25087091
UNLABELLED: Drug allergy is the third most common reason for allergy consultations. There is a tendency to call any adverse drug reaction (ADR) allergic, even without confirmatory allergy study. OBJECTIVES: (1) Evaluate time of resolution allergy to beta-lactam's study in a sample of 100 patients. (2) Analyse cost-effectiveness of current diagnostic study (skin tests, specific IgE and drug provocation test (DPT)). (3) Describe type and frequency of ADRs in adult/paediatric patients. (4) Compare cost of complete study with DPT. (5) Assess the need to restructure current study methodology according to results obtained. The study is part of a strategic plan of the allergy department (2005-2010). Patients with suspected allergy to beta-lactams were included. Procedures performed: medical history, specific IgE, skin tests and DPT. Cost/patient analysis. Cost of protocol analysis for current diagnostic/direct DPT. RESULTS: 100 patients were studied, 52 females/48 males; 43 children/57 adults. SYMPTOMS: 89 cutaneous, 4 anaphylaxis, 3 vasovagal reactions, 6 non-specific symptoms and 4 not recalled. Allergy was confirmed in six patients (only one child). Complete-study cost: 149.3 Euros/patient. DPT-study cost: 97.19 Euros/patient (34.9% less). Resolution time 9-13 months, absenteeism 28.04%. CONCLUSIONS: In the series studied, diagnosis of allergy to beta-lactams was confirmed in 6% of patients (2.3% of paediatric patients). After analysing results and cost of the study we believe that we should propose a specific diagnostic algorithm in those paediatric patients without suspected IgE-mediated ADR, and for those patients direct DPT should be conducted. This will reduce cost/patient (-34.9%), time of resolution and absenteeism.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pruebas Inmunológicas / Hipersensibilidad a las Drogas / Antibacterianos Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Idioma: En Revista: Allergol Immunopathol (Madr) Año: 2015 Tipo del documento: Article Pais de publicación: Singapur
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pruebas Inmunológicas / Hipersensibilidad a las Drogas / Antibacterianos Tipo de estudio: Diagnostic_studies / Guideline / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Idioma: En Revista: Allergol Immunopathol (Madr) Año: 2015 Tipo del documento: Article Pais de publicación: Singapur