title: Multinational experience with hypersensitivity drug reactions in Latin America.
abstract: BACKGROUND
  Epidemiologic drug allergy data from Latin America are scarce, and there are no studies on specific procedures focusing on this topic in Latin America.
  
  
  OBJECTIVE
  To assess the clinical characteristics and management of hypersensitivity drug reactions in different Latin American countries.
  
  
  METHODS
  An European Network of Drug Allergy questionnaire survey was implemented in 22 allergy units in 11 Latin American countries to report on consecutive patients who presented with a suspected hypersensitivity drug reaction. Each unit used its own protocols to investigate patients.
  
  
  RESULTS
  Included were 868 hypersensitivity drug reactions in 862 patients (71% of adults and elderly patients were women and 51% of children were girls, P = .0001). Children presented with less severe reactions than adults and elderly patients (P < .0001). Urticaria and angioedema accounted for the most frequent clinical presentations (71%), whereas anaphylaxis was present in 27.3% of cases. There were no deaths reported. Nonsteroidal anti-inflammatory drugs (52.3%), β-lactam antibiotics (13.8%), and other antibiotics (10.1%) were the drugs used most frequently. Skin prick tests (16.7%) and provocation tests (34.2%) were the study procedures most commonly used. A large proportion of patients were treated in the emergency department (62%) with antihistamines (68%) and/or corticosteroids (53%). Only 22.8% of patients presenting with anaphylaxis received epinephrine.
  
  
  CONCLUSIONS
  Nonsteroidal anti-inflammatory drugs and antibiotics were the drugs used in at least 75% of patients. More than half the reactions were treated in the emergency department, whereas epinephrine was administered in fewer than 25% of patients with anaphylaxis. Dissemination of guidelines for anaphylaxis among primary and emergency department physicians should be encouraged.
authors: Libra Foundation, Buenos Aires, Argentina. Electronic address: edgardo.jares@gmail.com.
authors: Edgardo José
authors: EJ
authors: Jares
authors: Clinica El Avila, Caracas, Venezuela.
authors: Mario
authors: M
authors: Sánchez-Borges
authors: Universidad de Antiquia, Medellin, Colombia.
authors: Ricardo
authors: R
authors: Cardona-Villa
authors: Universidade de Santo Amaro and Universidade Federal de São Paulo, Sao Paulo, Brazil.
authors: Luis Felipe
authors: LF
authors: Ensina
authors: Hospital Universitario, Monterrey, Mexico.
authors: Alfredo
authors: A
authors: Arias-Cruz
authors: Hospital San Bernardo, Salta, Argentina.
authors: Maximiliano
authors: M
authors: Gómez
authors: Nuevo Hospital San Roque, Córdoba, Argentina.
authors: Susana
authors: S
authors: Barayazarra
authors: University of Cincinnati, Cincinnati, Ohio.
authors: Jonathan A
authors: JA
authors: Bernstein
authors: Fundación Valle del Lili, Cali, Colombia.
authors: Carlos D
authors: CD
authors: Serrano
authors: Consultorios San Juan, San Juan, Argentina.
authors: Mabel Noemi
authors: MN
authors: Cuello
authors: Hospital Mocel, Mexico City, Mexico.
authors: Blanca María
authors: BM
authors: Morfin-Maciel
authors: Universidad Nacional de La Plata, La Plata, Argentina.
authors: Alicia
authors: A
authors: De Falco
authors: Respiralab, Hospital Kennedy, Guayaquil, Ecuador.
authors: Iván
authors: I
authors: Cherrez-Ojeda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology; D007223:Infant; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D055815:Young Adult