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. 2012 Jun 14;2(1):10.
doi: 10.1186/2045-7022-2-10.

Comprehensive allergy work-up is mandatory in cystic fibrosis patients who report a history suggestive of drug allergy to beta-lactam antibiotics

Silvia Caimmi  1 , Céline Sanfiorenzo, Davide Caimmi, Philippe-Jean Bousquet, Raphael Chiron, Pascal Demoly
Affiliations

Comprehensive allergy work-up is mandatory in cystic fibrosis patients who report a history suggestive of drug allergy to beta-lactam antibiotics

Silvia Caimmi et al. Clin Transl Allergy. .

Abstract

Background: In the general population, reports on suspected ß-lactam hypersensitivity are common. After a drug allergy work-up at best 20% of the selected patients are positive. However, these considerations have not been explored in cystic fibrosis patients for whom antibiotics are even more crucial.

Methods: The study, part of the Drug Allergy and Hypersensitivity (DAHD) cohort, was performed in the regional cystic fibrosis center of Montpellier, France. After identifying patients with a clinical history suggestive of drug allergy to ß-lactams, a complete drug allergy work-up, was carried out according to the EAACI recommendations.

Results: Among the 171 patients involved, 23 reported clinical manifestations potentially compatible with a drug allergy to ß-lactams. After performing the complete drug-allergy work-up, 7 were considered as drug hypersensitive (3 had positive skin tests, 1 a positive provocation test, 3 declined the tests). Excluding the latter 3 patients with incomplete drug allergy work-up, the rate of proven drug allergy was 2.3%.

Conclusions: Drug allergy to ß-lactams in cystic fibrosis patients is of importance. A full drug allergy work-up is mandatory in case of suspicion, because ß-lactam responsibility is often ruled out.

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Figures

Figure 1
Figure 1
Flow chart of the present study and of the results.Legend: BL: Beta-lactam; ST: Skin Tests; DPT: Drug Provocation Test.
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