Beta-Lactam Allergy De-Labeling Safe, Effective in Seniors

Medscape

2 days ago

Beta-lactam allergy de-labeling was safe and effective for older adult patients, successfully removing false allergy labels in 87.3% of cases, with no patients requiring hospitalization or adrenaline administration.
METHODOLOGY:
Researchers conducted a decade-long retrospective analysis to evaluate the safety and efficacy of beta-lactam allergy evaluations in older adult patients previously labeled as allergic.
The analysis included 166 older adult patients (mean age, 71 years; 72.9% women) who were evaluated between 2009 and 2019 for suspected beta-lactam allergy.
All participants underwent comprehensive anamnesis, skin testing, and, when indicated, an oral challenge; those who were successfully de-labeled underwent long-term follow-up to monitor beta-lactam use and outcomes.
TAKEAWAY:
Beta-lactam allergy was ruled out in 87.3% of patients; 9.6% had immediate-type hypersensitivity reactions, 2.4% had severe delayed-type hypersensitivity reactions, and 0.6% experienced a benign rash.
No participant required hospitalization or emergency adrenaline treatment during the evaluation.
In a long-term follow-up (3-13 years) of 106 patients, 35.8% were treated with the previously suspected beta-lactam agent, and no immediate-type or severe delayed-type hypersensitivity reactions were reported.
IN PRACTICE:
'Increased awareness is crucial for enhancing allergic workup in the geriatric population bearing beta-lactam allergy labels,' the authors wrote. 'We believe that establishing the removal rate of false BL [beta-lactam] allergy labels as a healthcare quality metric and making it mandatory under the supervision of health authorities will improve outcomes for both the general population and the geriatric population,' they added.
SOURCE:
Saray Sity-Harel, MD, with Tel-Aviv University, Tel-Aviv, Israel, was the corresponding author of the study, which was published online in Journal of Clinical Medicine .
LIMITATIONS:
This study had a single-center design and limited patient follow-up data, which may reduce the generalizability of the findings and the validity of the outcomes.
DISCLOSURES:
The authors reported having no conflicts of interest.