| Abstract [eng] |
Aim. The aim of this study is to analyse data from patients investigated in 2024 at the Day Care Unit for Allergic and Immune Diseases of Vilnius University Hospital Santaros Clinics, to asses how many patietns have a confirmed allergy to penicillin-class antibiotics, to examine clinical phenotypes of allergic reactions and diagnostic possibilites, and to provide evidence-based recommentadions for patients and healthcare professionals. To compare the data with findings in the literature. Methods. The collected data analysis was performed using Microsoft Office Excel (Version 16.107.3). Wilson score was used to calculate confidence intervals, and Chi-square test for p-value. Results are considered statistically significant when p-value obtained is < 0,05. Calculations were performed in Microsoft Office Excel, using formulas and Analysis ToolPak equipment. A literature review was also conducted in scientific databases – PubMed, ScienceDirect, MSD Manual, Nature Cell and Science, National Library of Medicine, American Journal of Medical and Clinical Sciences – collecting data on the structure of penicillins, classification, allergy to this group of drugs, its prevalence, diagnostic methods. Objectives. 1. To describe the demographic and clinical characteristics of the patients with suspected allergy to penicillin-class antibiotics. 2. To assess the proportion of patients whose allergy to penicillin-class antibiotics was confirmed or denied by skin and provocation tests. 3. To discuss the obtained results, compare them with the literature and prepare possible practical recommendations for doctors and patients. Results. The conducted study showed that 35,9% (33 out of 92 patients) have a true allergy to penicillin-class antibiotics, confirmed by allergological testing. In 20 patients, the allergy was confirmed by skin tests, while in 13 patients it was confirmed by provocation tests. The results also revealed that medical records indicating a previous possible allergic reaction do not increase the likelihood of positive allergological test results. Amoxicillin was the most frequently suspected causative agent (73,9%). The obtained results are consistent with those reported by specialized centers both in Lithuania and across Europe. Several cases of cross-reactivity were also identified in the study – two patients allergic to amoxicillin exhibited allergic reactions to piperacillin/tazobactam. One patient reacted to amoxicillin, ampicilin, cefuroxime and meropenem. Conclusions. The results obtained during the study emphasize the importance of “delabeling” the diagnosis of allergy – 58,7% of patients in the total sample can safely use penicillin-class antibiotics after allergological evaluation. When an allergy to one of the penicillins is suspected or confirmed, it is not necessary to automatically avoid all drugs in this group; instead, based on a thorough medical history and the results of allergological tests, a safe and appropriate alternative should be selected for the patient. Unjustified avoidance of medications may complicate the treatment of infectious diseases and contribute to the increase of antimicrobal resistance in society. Keywords. Penicillin antibiotics, allergy, diagnostics, skin tests, provocation tests. |
