Current opinion in allergy and clinical immunology · 2025
Algorithms for the classification of patients with a β-lactam allergy label: a systematic review.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Sousa Joana, Balseiro Joana, Barreto Mariana, Mendes Francisca, Pereira Ana Margarida, Ribeiro-Vaz Inês, Cruz-Correia Ricardo, Sousa-Pinto Bernardo
Аннотация
PURPOSE OF REVIEW: Beta-lactam allergy is frequently reported, but only a minority of cases correspond to true allergies. Tools to stratify the risk of a real allergic reaction can possibly help delabeling patients. We aimed to retrieve evidence on algorithms for risk stratification of patients with a beta-lactam allergy label.
RECENT FINDINGS: We performed a systematic review, searching three databases and included 28 studies. Most of the applied tools involved the assessment of the presence of rash/hives/other exanthemas ( n = 24), angioedema/localized swelling ( n = 23), bronchospasm/wheezing/dyspnea ( n = 22) and gastrointestinal symptoms ( n = 21). Seventeen studies classified participants into different categories according to their risk of having a penicillin allergy; three studies presented algorithms indicating management approaches to be followed; six studies applied predictive models. Most studies had a high risk of bias, particularly concerning the reference standard and lack of external validation.
SUMMARY: Existing algorithms for beta-lactam allergy risk stratification are very heterogeneous and most of them lack validation.
RECENT FINDINGS: We performed a systematic review, searching three databases and included 28 studies. Most of the applied tools involved the assessment of the presence of rash/hives/other exanthemas ( n = 24), angioedema/localized swelling ( n = 23), bronchospasm/wheezing/dyspnea ( n = 22) and gastrointestinal symptoms ( n = 21). Seventeen studies classified participants into different categories according to their risk of having a penicillin allergy; three studies presented algorithms indicating management approaches to be followed; six studies applied predictive models. Most studies had a high risk of bias, particularly concerning the reference standard and lack of external validation.
SUMMARY: Existing algorithms for beta-lactam allergy risk stratification are very heterogeneous and most of them lack validation.