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Article: Prevalence, Incidence, and Sensitization Profile of β-lactam Antibiotic Allergy in Hong Kong
Title | Prevalence, Incidence, and Sensitization Profile of β-lactam Antibiotic Allergy in Hong Kong |
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Authors | |
Keywords | Drug Hypersensitivity Penicillin Beta-Lactam |
Issue Date | 2020 |
Publisher | American Medical Association. The Journal's web site is located at https://jamanetwork.com/journals/jamanetworkopen |
Citation | JAMA Network Open, 2020, v. 3 n. 5, p. article no. e204199 How to Cite? |
Abstract | Importance: Allergy to β-lactam antibiotics is one of the most frequently reported drug reactions, but epidemiological data in Chinese populations are lacking. Ethnic- and region-specific sensitization patterns of skin testing for β-lactam antibiotic allergy are also unknown.
Objective: To identify the prevalence, 1-year incidence, and sensitization patterns of β-lactam antibiotic allergy in patients in Hong Kong.
Design, Setting, and Participants: This cross-sectional study obtained territorywide, anonymized electronic patient data from the Clinical Management Systems of the Hospital Authority, the sole publicly funded health care system in Hong Kong with facilities in 7 regions (Hong Kong East, Hong Kong West, Kowloon Central, Kowloon East, Kowloon West, New Territories East, and New Territories West). All referrals to Queen Mary Hospital for β-lactam antibiotic allergy testing from January 1, 2018, to December 31, 2019, were also analyzed for sensitization patterns.
Main Outcomes and Measures: Prevalence and cumulative incidence of β-lactam antibiotic allergy reported in Hong Kong, and sensitization patterns according to β-lactam antibiotic allergy skin testing.
Results: Complete records of 7 184 271 unique patients were analyzed, with a men to women ratio of 1:1.2 and with a median age of 44 years. The prevalence of physician-reported β-lactam antibiotic allergy was 2.0%, and the cumulative incidence was 107 per 100 000 population. Of the 34 402 new drug allergies reported in 2018, 8032 (23.3%) were β-lactam antibiotic allergies. Three hundred fifty-five patients with reactions suggestive of β-lactam antibiotic allergy underwent skin testing, and only 49 (13.8%; 95% CI, 10.64%-17.90%) of them had positive test results. Of these 49 patients, 14 (28.6%; 95% CI, 18.35%-44.49%) had selective reaction and 35 (71.4%; 95% CI, 59.84%-85.27%) had nonselective reaction. The sensitization rate to either benzylpenicilloyl polylysine or a minor determinant (benzylpenicilloate) was 47.0% (n = 23; 95% CI, 34.85%-63.21%), with 10 patients monosensitized to benzylpenicilloyl polylysine only (20.4%; 95% CI, 11.74%-35.48%) and 5 to benzylpenicilloate only (10.2%; 95% CI, 4.45%-23.42%).
Conclusions and Relevance: Results of this study suggest that patients in Hong Kong with β-lactam antibiotic allergy had much higher rates of monosensitization to benzylpenicilloyl polylysine and benzylpenicilloate, making these reagents essential in β-lactam antibiotic skin tests. Such a finding warrants future studies into whether this sensitization is specific to ethnicity or region. |
Persistent Identifier | http://hdl.handle.net/10722/283256 |
ISSN | 2023 Impact Factor: 10.5 2023 SCImago Journal Rankings: 3.478 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Li, PH | - |
dc.contributor.author | Yeung, HHF | - |
dc.contributor.author | Lau, CS | - |
dc.contributor.author | Au, EYL | - |
dc.date.accessioned | 2020-06-22T02:54:13Z | - |
dc.date.available | 2020-06-22T02:54:13Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | JAMA Network Open, 2020, v. 3 n. 5, p. article no. e204199 | - |
dc.identifier.issn | 2574-3805 | - |
dc.identifier.uri | http://hdl.handle.net/10722/283256 | - |
dc.description.abstract | Importance: Allergy to β-lactam antibiotics is one of the most frequently reported drug reactions, but epidemiological data in Chinese populations are lacking. Ethnic- and region-specific sensitization patterns of skin testing for β-lactam antibiotic allergy are also unknown. Objective: To identify the prevalence, 1-year incidence, and sensitization patterns of β-lactam antibiotic allergy in patients in Hong Kong. Design, Setting, and Participants: This cross-sectional study obtained territorywide, anonymized electronic patient data from the Clinical Management Systems of the Hospital Authority, the sole publicly funded health care system in Hong Kong with facilities in 7 regions (Hong Kong East, Hong Kong West, Kowloon Central, Kowloon East, Kowloon West, New Territories East, and New Territories West). All referrals to Queen Mary Hospital for β-lactam antibiotic allergy testing from January 1, 2018, to December 31, 2019, were also analyzed for sensitization patterns. Main Outcomes and Measures: Prevalence and cumulative incidence of β-lactam antibiotic allergy reported in Hong Kong, and sensitization patterns according to β-lactam antibiotic allergy skin testing. Results: Complete records of 7 184 271 unique patients were analyzed, with a men to women ratio of 1:1.2 and with a median age of 44 years. The prevalence of physician-reported β-lactam antibiotic allergy was 2.0%, and the cumulative incidence was 107 per 100 000 population. Of the 34 402 new drug allergies reported in 2018, 8032 (23.3%) were β-lactam antibiotic allergies. Three hundred fifty-five patients with reactions suggestive of β-lactam antibiotic allergy underwent skin testing, and only 49 (13.8%; 95% CI, 10.64%-17.90%) of them had positive test results. Of these 49 patients, 14 (28.6%; 95% CI, 18.35%-44.49%) had selective reaction and 35 (71.4%; 95% CI, 59.84%-85.27%) had nonselective reaction. The sensitization rate to either benzylpenicilloyl polylysine or a minor determinant (benzylpenicilloate) was 47.0% (n = 23; 95% CI, 34.85%-63.21%), with 10 patients monosensitized to benzylpenicilloyl polylysine only (20.4%; 95% CI, 11.74%-35.48%) and 5 to benzylpenicilloate only (10.2%; 95% CI, 4.45%-23.42%). Conclusions and Relevance: Results of this study suggest that patients in Hong Kong with β-lactam antibiotic allergy had much higher rates of monosensitization to benzylpenicilloyl polylysine and benzylpenicilloate, making these reagents essential in β-lactam antibiotic skin tests. Such a finding warrants future studies into whether this sensitization is specific to ethnicity or region. | - |
dc.language | eng | - |
dc.publisher | American Medical Association. The Journal's web site is located at https://jamanetwork.com/journals/jamanetworkopen | - |
dc.relation.ispartof | JAMA Network Open | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Drug Hypersensitivity | - |
dc.subject | Penicillin | - |
dc.subject | Beta-Lactam | - |
dc.title | Prevalence, Incidence, and Sensitization Profile of β-lactam Antibiotic Allergy in Hong Kong | - |
dc.type | Article | - |
dc.identifier.email | Li, PH: liphilip@HKUCC-COM.hku.hk | - |
dc.identifier.email | Lau, CS: cslau@hku.hk | - |
dc.identifier.authority | Li, PH=rp02669 | - |
dc.identifier.authority | Lau, CS=rp01348 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1001/jamanetworkopen.2020.4199 | - |
dc.identifier.pmid | 32374398 | - |
dc.identifier.pmcid | PMC7203606 | - |
dc.identifier.scopus | eid_2-s2.0-85084328121 | - |
dc.identifier.hkuros | 310335 | - |
dc.identifier.volume | 3 | - |
dc.identifier.issue | 5 | - |
dc.identifier.spage | article no. e204199 | - |
dc.identifier.epage | article no. e204199 | - |
dc.identifier.isi | WOS:000534036000004 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 2574-3805 | - |