388 Drug Hypersensitivity Reactions in Hospitalized Patients: What is the Role of the Allergist?

BACKGROUND: Ten-to-twenty percent of hospitalized patients experience drug adverse reactions. There are few epidemiological data of drug hypersensitivity in inpatients in brazilian population. Our aim was to analyze the main clinical and epidemiological data of drug hypersensitivity reactions in hospitalized patients and to assess the importance of the allergist's evaluation. METHODS: A prospective study was developed in an Allergy Clinic of a Service in São Paulo, Brazil, from January 2010 to January 2011. We evaluated the cases in which the allergist was assessed. The patients were studied based on history of hypersensitivity reactions to drugs (HRD) using an adapted ENDA (European Network of Drug Allergy) questionnaire. We analyzed clinical and epidemiological data of drug hypersensitivity reactions and assessed differences of the allergist evaluation. RESULTS: Of all 80 cases in which the allergist was assessed, 65 (81%) were for HRD. The mean age was 57 years, 49 (75%) were women. Fifty (89%) experienced non-immediate reactions, 8 of them were severe adverse cutaneous reactions. Eight (12%) had just positive history of HRD, without reaction at the time of the evaluation. Neurosurgery (15), Infectious Diseases (11), Vascular surgery (8) were the main Clinics who assessed our specialty. Non-steroidal anti-inflammatory drugs (21), antiepileptics (16) and non-β-lactams antibiotics (15) were the most important pharmacological groups. Thirty (46%) patients were in use of more than 5 drugs at the time of the reaction, but in 46 (70%) evaluations there was 01 culprit drug suspected by the allergist. There was discordance between the allergist and the non-allergist opinion about the suspected drug in 13 (20%) cases. In 50% of cases other Clinics were assessed for the same reason. Eleven (17%) patients had history of HRD with the same pharmacological group before. CONCLUSIONS: HRD is the main cause why the allergist is assessed. The pharmacological groups related to these HRD were different from the previously described. The history of HRD is still not appropriate asked from the non-allergists. The evaluation of the allergist can help to manage HRD properly.