Acute or Chronic spontaneous urticaria patients report increased rates of medication allergies.
Author ORCID Identifier
Allergy, Asthma & Clinical Immunology
acute urticaria, chronic spontaneous urticaria, medication allergies
The pathophysiology of acute urticaria and chronic spontaneous urticaria (CSU) is not completely known. Antibiotic allergies are on the rise, and the typical history is associated with urticarial reactions which can persist. Given this overlap, we sought to determine whether self-reported antibiotic allergies are increased in patients with a history of acute urticaria or CSU.
Retrospective chart review of 950 patients was completed using the electronic medical record of the Windsor Allergy & Asthma Clinic. Cases were identified to have a history of acute urticaria or CSU, whereas controls have an established diagnosis of food allergies, asthma, allergic rhinitis or non-allergic rhinitis. The number of reported medication and antibiotic allergies were compared between the case and control groups using Pearson’s chi square analyses.
Patients with a history of urticaria were more likely to report an antibiotic allergy than would be expected by chance when compared to our control group (p = 0.023). A total of 42/239 (17.6%) patients with a history of urticaria (acute or chronic) vs 82/711 (12%) of the control group reported one antibiotic allergy. Additionally, 8/239 (3.3%) of our cases (acute or chronic) versus 14/711 (2%) of our control group reported 2 antibiotic allergies. Subgroup analyses looking at whether the nature of urticaria, acute vs. chronic, affected the allergy reporting risk did not find a significant difference. Both groups were more likely to report antibiotic allergies when compared to the control group (p= 0.036)
These results raise concern regarding the nature of self-reported antibiotic allergies in patients with a history of urticaria. These “antibiotic allergies” may be a result of concomitant urticarial exacerbations rather than truly IgE mediated mechanisms. This has implications on choice of antibiotic agents in the era of antibiotic stewardship and growing microbial resistance.
Clark, Brandon; Bornais, Judy; Miller, Scott; and Liem, Joel. (2021). Acute or Chronic spontaneous urticaria patients report increased rates of medication allergies.. Allergy, Asthma & Clinical Immunology, 17 (Suppl 1).