ABSTRACT
Background: In our setting,it is common for patients to be “labelled” as allergic in the presence of doubtful clinical signs of intolerance or allergic reaction. Moreover,it is not uncommon that patients who have been ruled out allergy to beta-lactam antibiotics (BL-ATB) continue to be mislabelled allergologically in the electronic medical records.Unfortunately,this mistake means that they are sometimes deprived of the first therapeutic option. Objective: The main objective of the study was to assess the correct labelling of patients(p) from an allergological point of view in Primary Care,in the Emergency Department and in visits to other specialists. The secondary objectives were:to determine the percentage of patients who received BL-ATB, the reason for the prescription and the drugs used. Method: Prospective review of the medical records of 92 patients who have been ruled out allergy to BL-ATB in our department during the months of August 1st,2019, to March 31st,2020.All patients have been followed for at least 12 months.Data were collected by reviewing the electronic medical records. Results: Of the 92 patients, only 64%(54p) were well identified in primary care. Only 36%(33p) had attended the Emergency Department,of which 76%(25p) were correctly identified and the remaining 24%(8p) were not. 38%(35p) were visited by an specialist, in a total of 42 visits(v). In 74% of the visits (31v) the patients were correctly identified and in the remaining 26% they were not.Table 1 summarises the number of visits to each specialist and the correct or incorrect allergological identification. Only 17%(16p) received BL-ATB, on a total of 20 occasions.Urinary tract infections were the most frequent reason for prescribing BL-ATB (4p), followed by H.Pilory infection(3p),skin infections(3p),respiratory infections(3p),sepsis (2p),acute otitis media(1p),pharyngitis(1p),sinusit is(1p),oral infections(1p) and bone fractures(1p). Amoxicillin was the most commonly used drug(8p),followed by Amoxicillin/Clavulanic acid(5p),Cefuroxime(2p),Meropenem(2p),Cef triaxone (1p) and Piperacillin/Tazobactam(1p). Conclusion: Despite the efforts being made by Allergology services to correctly label patients with HS to BL, a high percentage remain misidentified. In relation to the consumption of BL-ATB, we believe that the data are underestimated,given that during the months of follow-up of the study (year 2020) the use of masks and hand washing recommended by the COVID-19 pandemic have reduced both infections and access to health care. (Table Presented).