Drug allergy: fact or fiction?
From our clinical practice, it was apparent that patients often reported drug allergies without a substantiating history. A prospective study over six months was undertaken to examine the reporting of drug allergies by hospital patients. Based on the history, allergic reactions were triaged into one of three categories: high probability of an allergic reaction, low probability of an allergic reaction, and uncertain, where the history was incomplete or unclear. Of 1519 patients interviewed, 133 (9%) reported prior drug allergies. The most commonly implicated agents were penicillin (74%), septrin (6%), aspirin (6%), cefuroxime (2%) and trimethoprim (2%); 61% of reactions were deemed to be high probability, with the remainder either low (29%) or uncertain (10%) probability. It was apparent that patients often considered drug allergy to be synonymous with adverse reaction. Preventing patients from being labelled as drug allergic, thus being denied therapy with first-line agents, requires patient education and vigilance by doctors in their history-taking.
Bowrey
D J
DJ
East Glamorgan Hospital, Pontypridd, Wales.
Morris-Stiff
G J
GJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal