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Penicillin-Allergie ­ tödliche "Fake News" in der Krankenakte? / [Penicillin Allergy - Deadly "Fake News" in the Medical Record?]

Schulz-Stübner, Sebastian.
Artigo em Alemão | MEDLINE | Fev 2020 | ID: mdl-32069481
Resumo: The note "penicillin allergy" in the medical record is given in the literature with a prevalence of 8 - 12% and represents the most frequently reported "allergy". However, there are a number of hypersensitivity reactions of which true anaphylaxis is only a small part. Therefore, a specific allergy history should be included in the file for patients with suspected penicillin allergy. Even a simple survey can identify those patients who can easily obtain cephalosporin, especially cefazolin. Any unclear history of antibiotic allergy should be followed by a stepwise allergological diagnosis. This is because suspected allergies are associated with an increased rate of postoperative wound infections when alternatives to preoperative prophylaxis are used and a general increase in mortality, presumably due to poorly effective therapies and increased side effects. The article explains the risk stratification for the evaluation of a penicillin allergy, shows reasons for insufficient clarification and incorrect documentation of allergy anamnesis and describes diagnosis and therapy of true anaphylaxis.