Drug allergy in tertiary care in Turkey: results of a national survey. The ADAPT study: adult drug allergy perception in Turkey

Allergol Immunopathol (Madr). 2014 Nov-Dec;42(6):573-9. doi: 10.1016/j.aller.2013.07.007. Epub 2013 Oct 23.

Abstract

Background: No data are available on the incidence of drug hypersensitivity (DH) reactions in outpatient settings of tertiary allergy/immunology clinics. Our aims were to document the frequency of outpatient hospital admissions due to DH reactions to allergy/immunology clinics in adults and the management of these reactions in real life. We also investigated whether drug allergy affected social and medical behaviours of the patients.

Methods: This multi-centre study was performed for one year with the participation of 11 out of 16 tertiary allergy/clinical immunology clinics in Turkey. The study group consisted of the patients with DH reactions. Results of a questionnaire including drug reactions and management were recorded.

Results: Among 54,863 patients, 1000 patients with DH were enrolled with a median of 2.1% of all admissions. In real life conditions, the majority of approaches were performed for finding safe alternatives (65.5%; 1102 out of 1683) with 11.7% positivity. Diagnostic procedures were positive in 27% (154/581) of the patients. The majority of the patients had higher VAS scores for anxiety. A total of 250 subjects (25%) reported that they delayed some medical procedures because of DH.

Conclusion: Our results documented the frequency of admissions due to DH reactions to allergy/clinical immunology clinics for the first time. Although physicians mostly preferred to perform drug tests in order to find safe alternatives, considering the fact that DH was confirmed in 27% of the patients, use of diagnostic tests should be encouraged, if no contraindication exists in order to avoid mislabelling patients as DH.

Keywords: Drug allergy; Drug hypersensitivity; Drug provocation tests; Epidemiology; Guidelines; Skin prick tests.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Allergens / adverse effects
  • Allergens / immunology
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Anxiety Disorders / epidemiology*
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / epidemiology*
  • Female
  • Hospitals, Special / statistics & numerical data*
  • Humans
  • Immunization
  • Male
  • Patient Admission / statistics & numerical data*
  • Perception
  • Tertiary Healthcare / statistics & numerical data*
  • Turkey
  • beta-Lactams / adverse effects
  • beta-Lactams / therapeutic use

Substances

  • Allergens
  • Anti-Inflammatory Agents, Non-Steroidal
  • beta-Lactams