The journal of allergy and clinical immunology. In practice
-
J Allergy Clin Immunol Pract · May 2014
A multifaceted intervention for patients with anaphylaxis increases epinephrine use in adult emergency department.
Studies have documented inconsistent emergency anaphylaxis care and low compliance with published guidelines. ⋯ Significantly higher proportions of patients with anaphylaxis received epinephrine and were admitted to the ED observation unit after introduction of epinephrine autoinjectors and order set implementation. Slightly more than half of the biphasic reactions occurred within the recommended observation time of 4 to 6 hours. Analysis of these data suggests that the multifaceted approach to changing anaphylaxis management described here improved guideline adherence.
-
J Allergy Clin Immunol Pract · Mar 2014
Validation of parental reports of asthma trajectory, burden, and risk by using the pediatric asthma control and communication instrument.
Despite a growing interest, few pediatric asthma questionnaires assess multiple dimensions of asthma morbidity, as recommended by national asthma guidelines, or use patient-reported outcomes. ⋯ PACCI Direction, Bother, and Risk are valid measures of parent-reported outcomes and show good discriminative validity. The PACCI is a simple clinical tool to assess multiple dimensions of parent-reported asthma morbidity, in addition to risk and control.
-
J Allergy Clin Immunol Pract · Mar 2014
Alcohol-induced respiratory symptoms are common in patients with aspirin exacerbated respiratory disease.
A large percentage of patients with aspirin exacerbated respiratory disease (AERD) report the development of alcohol-induced respiratory reactions, but the true prevalence of respiratory reactions caused by alcoholic beverages in these patients was not known. ⋯ Alcohol ingestion causes respiratory reactions in the majority of patients with AERD, and clinicians should be aware that these alcohol-induced reactions are significantly more common in AERD than in controls who are aspirin tolerant.
-
J Allergy Clin Immunol Pract · Jan 2014
Retrospective study of drug-induced anaphylaxis treated in the emergency department or hospital: patient characteristics, management, and 1-year follow-up.
Drugs are a common cause of anaphylaxis, which is potentially life threatening. ⋯ Drugs are a common, yet under-recognized, cause of anaphylaxis. Only a small number of patients with DIA received epinephrine in the ED or had subsequent care with an allergist/immunologist. These findings are novel and identify areas for improvement in the care of individuals with DIA.
-
J Allergy Clin Immunol Pract · Jan 2014
ReviewAntibiotic allergies in children and adults: from clinical symptoms to skin testing diagnosis.
Hypersensitivity reactions to β-lactam and non-β-lactam antibiotics are commonly reported. They can be classified as immediate or nonimmediate according to the time interval between the last drug administration and their onset. Immediate reactions occur within 1 hour after the last drug administration and are manifested clinically by urticaria and/or angioedema, rhinitis, bronchospasm, and anaphylactic shock; they may be mediated by specific IgE-antibodies. ⋯ Immediate reactions can be assessed by immediate-reading skin tests and, in selected cases, drug provocation tests. Nonimmediate reactions can be assessed by delayed-reading skin tests, patch tests, and drug provocation tests. However, skin tests have been well validated mainly for β-lactams but less for other classes of antibiotics.