gms | German Medical Science

83. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

16.05. - 20.05.2012, Mainz

Penicillin allergy in autoanamnesis – evaluation of a questionnaire

Meeting Abstract

  • corresponding author Jörg-Michael Nebel - Bundeswehrkrh., Koblenz, Germany
  • presenting/speaker Doris Bücher-Ollig - Bundeswehrkrh., HNO-Abt., Koblenz, Germany
  • presenting/speaker Maria Frieß - Bundeswehrkrh., HNO-Abt., Koblenz, Germany
  • presenting/speaker Roland Jacob - Bundeswehrkrh., HNO-Abt., Koblenz, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Mainz, 16.-20.05.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12hno06

DOI: 10.3205/12hno06, URN: urn:nbn:de:0183-12hno066

Veröffentlicht: 23. Juli 2012

© 2012 Nebel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: During anamnesis up to 10% of the patients report a penicillin allergy in the past. It is well known that a high percentage of those patients do not suffer from a real penicillin allergy, but rather a penicillin hypersensitivity, side effects or simply coincidences. Since testing is neither safe nor quick, those patients are treated with second or third line antibiotics, instead of a treatment according to guidelines. Unfortunately this behavior potentially causes antibiotic resistance.

Method: Patients, who report a penicillin allergy, were questioned with the “questionnaire for drug allergy” from the European academy of allergy und clinical immunology. This is a very detailed questionnaire including symptoms, medication, treatment, …

Additionally we asked for an allergy pass, medical documentation, such as medical report,… and had a close look for possible hints of a mononucleosis.

Optional patients could have their total IgE, the specific IgE of penicillin and the specific IgE of the consumed antibiotic tested. The IgE-test is one of the safest and easiest test on drug allergies, but loses its significance with every year after the exposure and its allergic? reaction.

Results: We asked 17 patients and 9 of them tested the IgE. The patients were between 19 und 67 years old. The reactions are dated back between 2 and 60 years.

One positive IgE-test for penicillin.

13 described dermal reactions such as exanthema (either general or on the antecubital fossa).

One described a gastrointestinal cramp and three did not know about the reaction, as they were too young to remember, but were informed by their parents or a pediatrician. Two patients had an allergy pass, which revealed a cefuroxime and amoxicillin allergy, although a penicillin allergy was reported.

One patient is considered to suffer from a mononucleosis.

The one positively tested IgE-patient was tested in 2005 after the reaction, but did not possess an allergy pass.

Asking for the antibiotic name, twelve patients were in doubt of the exact name of either drug or ingredient.

Conclusion: Along with findings of other studies, we determined the reported number of penicillin allergies to be higher than the real one. Nevertheless it is still impossible to find an easy and safe test for antibiotic allergy for clinical use, as reported before.

Surprisingly a majority of the affected patients is is considerably misinformed c using the name penicillin synonymously for the drug class of antibiotics, leading to a deceitful risc in using other antibiotics instead of penicillin.

The short question, if the patient is certain about the product name, can be profitable for patients security.