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Ann Allergy Asthma Immunol. 2014 Sep;113(3):282-9. doi: 10.1016/j.anai.2014.06.019. Epub 2014 Jul 24.

Multinational experience with hypersensitivity drug reactions in Latin America.

Author information

1
Libra Foundation, Buenos Aires, Argentina. Electronic address: edgardo.jares@gmail.com.
2
Clinica El Avila, Caracas, Venezuela.
3
Universidad de Antiquia, Medellin, Colombia.
4
Universidade de Santo Amaro and Universidade Federal de São Paulo, Sao Paulo, Brazil.
5
Hospital Universitario, Monterrey, Mexico.
6
Hospital San Bernardo, Salta, Argentina.
7
Nuevo Hospital San Roque, Córdoba, Argentina.
8
University of Cincinnati, Cincinnati, Ohio.
9
Fundación Valle del Lili, Cali, Colombia.
10
Consultorios San Juan, San Juan, Argentina.
11
Hospital Mocel, Mexico City, Mexico.
12
Universidad Nacional de La Plata, La Plata, Argentina.
13
Respiralab, Hospital Kennedy, Guayaquil, Ecuador.

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.

CONCLUSION:

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.

PMID:
25065979
DOI:
10.1016/j.anai.2014.06.019
[Indexed for MEDLINE]

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