Drug-induced anaphylaxis in the emergency department: A prospective observational study

OBJECTIVE: Anaphylaxis is an acute, life-threatening, systemic hypersensitivity reaction. It is usually triggered by drugs, foods, and insect stings. The primary objective of our study is to determine the factors affecting drug-induced anaphylaxis to contribute to early diagnosis and treatment in these patients.
METHODS: Patients over 18 years old who were diagnosed drug-induced anaphylaxis in the Goztepe Hospital within a period of 1 year were evaluated prospectively. Patients demographical data, etiological factors, clinical findings, and treatment information were recorded.
RESULTS: Forty-four patients were enrolled in the study of which 25 (56.8%) were female. The median age of women and men was 54 (min: 22, max 82) and 44 (min 18, max 82), respectively. Twenty-three (52%) of them had a history of anaphylaxis. The most common causes of drug-induced anaphylaxis were antibiotics (36%) and nonsteroidal anti-inflammatory drugs (18%), respectively. Adrenaline was applied to 17 (38%) of the patients in the treatment.
CONCLUSION: Antibiotics were the most common drugs causing drug-induced anaphylaxis and adrenaline was underused which is the first-line treatment in the anaphylaxis. Some clinicians refrain from administering adrenaline. The reasons underlying this approach should be investigated.

Acil Serviste Ýlaca Baðlý Anaflaksi-Prospektif Gözlemsel Çalýþma

Giriþ: Anaflaksi; akut geliþen, hayatý tehdit edebilen, sistemik bir aþýrý duyarlýlýk reaksiyonudur. Genellikle ilaçlara, gýdalara ve böcek sokmalarýna baðlý tetiklenir.
Çalýþmamýzýn amacý ilaca baðlý geliþen anaflaksiye etki eden faktörleri araþtýrmak ve bu hastalarda erken taný ve tedaviye katký saðlamaktýr.
Metod: Prospektif bir çalýþma olup 1 yýl suresince xxx Hastanesi acil servisinde ilaca baðlý anaflaksi tanýsý alan 18 yaþ üzeri olgular deðerlendirilmiþtir. Hastalarýn demografik verileri, etiyolojik faktörler, klinik bulgular, tedavi bilgileri kaydedilmiþtir.
Bulgular: Çalýþmaya 25 (%56,8) i kadýn toplam 44 hasta dahil edildi. Kadýnlarda yaþ ortanca deðeri 54 (min: 22, maksimum 82), erkeklerde yaþ ortanca deðeri 44 ( min 18, max 82) idi. 23 (%52)’ ünün daha önceden de anaflaksi öyküsü vardý. Sýrasýyla en sýk nedenler antibiyotikler (%36) ve nonsteroid anti-inflamatuvar ilaçlar (%18) idi. Tedavide hastalarýn 17(%38)’sine adrenalin uygulanmýþtý.
Sonuçlar: Antibiyotikler ilaca baðlý anaflaksiye en sýk neden olan ilaçlardýr. Anaflaksi tedavisinde birinci basamak tedavi olan adrenalin uygulamasýnýn geride kaldýðý görülmüþtür.Bazý klinisyenler antibiyotik uygulamasýndan çekiniyorlar. Bunun nedenlerinin araþtýrýlmasý gerekir. (NCI-2020-0295.R1)