• Edgardo José Jares, Carlos E Baena-Cagnani, Mario Sánchez-Borges, Luis Felipe C Ensina, Alfredo Arias-Cruz, Maximiliano Gómez, Mabel Noemi Cuello, Blanca María Morfin-Maciel, Alicia De Falco, Susana Barayazarra, Jonathan A Bernstein, Carlos Serrano, Silvana Monsell, Juan Schuhl, Ricardo Cardona-Villa, and Latin America Drug Allergy Interest Group.
• Allergy Unit, CMP S.A., Libra Foundation, Buenos Aires, Argentina. Electronic address: edgardo.jares@gmail.com.
• J Allergy Clin Immunol Pract. 2015 Sep 1; 3 (5): 780-8.

BackgroundInformation regarding the clinical features and management of drug-induced anaphylaxis (DIA) in Latin America is lacking.ObjectiveThe objective of this study was to assess implicated medications, demographics, and treatments received for DIA in Latin American patients referred to national specialty centers for evaluation.MethodA database previously used to compile information on drug-induced allergic reactions in 11 Latin American countries was used to identify and characterize patients presenting specifically with a clinical diagnosis of DIA. Information regarding clinical presentation, causative agent(s), diagnostic studies performed, treatment, and contributing factors associated with increased reaction severity was analyzed.ResultsThere were 1005 patients evaluated for possible drug hypersensitivity reactions during the study interval, and 264 (26.3%) met criteria for DIA. DIA was more frequent in adults and in elderly females (N = 129 [76.6%] and N = 30 [75%], respectively) compared with children and/or adolescents (N = 21 [42.9%], P < .01). Severe DIA was less frequent with underlying asthma (N = 22 vs 35 [38.6% vs 61.4%], P < .05) or atopy (N = 62 vs 71 [43% vs 59% ], P < .01). Nonsteroidal anti-inflammatory drugs (NSAIDs) (N = 178 [57.8%]), beta-lactam antibiotics (N = 44 [14.3%]), and other antibiotics (N = 16 [5.2%]) were the most frequently implicated drug classes. Anaphylaxis was rated as severe in N = 133 (50.4%) and anaphylactic shock (AS) was present in N = 90 (34.1%). Epinephrine was only used in N = 73 (27.6%) overall, but in N = 70 (77.8%) of patients with AS.ConclusionIn Latin American patients referred for evaluation of DIA, NSAIDs and antibiotics were implicated in approximately 80% of cases. Most of these reactions were treated in the emergency department. Epinephrine was administered in only 27.6% of all cases, although more frequently for anaphylactic shock. Dissemination of anaphylaxis guidelines among emergency department physicians should be encouraged to improve management of DIA.Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

33 keywords...

hide…