Correlation of Antibiotic Allergy Frequency and Problematic Diagnoses

Abstracts AB167 J ALLERGY CLIN IMMUNOL VOLUME 141, NUMBER 2 Correlation of Antibiotic Allergy Frequency and Problematic Diagnoses Thomas Bebekoski1, Carl B. Lauter, MD, FAAAAI2, and Matthew Sims2,3; 1OUWB School of Medicine, Rochester Hills, MI, 2William Beaumont Hospital, Royal Oak, MI, 3OUWB School if Medicine, Rochester Hills, MI. RATIONALE: After noting that inpatients who had consultations placed to Infectious Diseases for choice of therapy given multiple antibiotic allergies frequently carried diagnoses associated with a preponderance of somatic complaint, we undertook to analyze the association between the number of reported allergies and such diagnosis. METHODS: For the year 2015 all inpatients at Beaumont Royal Oak, Troy, and Grosse Pointe were reviewed for antibiotic allergies and total number of allergies listed in the EPIC electronic medical record. The problem list and past medical history were obtained for each of these patients. Diagnoses and number of reported allergies were examined to determine the correlation between the numbers of reported allergies and various diagnoses. RESULTS: For the year 2015, 35,304 unique patients were identified with any reported allergy, of which 19,284 had a reported antibiotic allergy. The number of reported allergies varied from 1 to 62; 5828 reported a single _10 allergies (4.71%), and 114 reported allergy (30.22%), 908 reported > _20 allergies (0.59%). There was a strong association between multiple > allergies and fibromyalgia and interstitial cystitis. There was a neutral association between multiple allergies and fracture, lymphoma, anxiety, and GERD. CONCLUSIONS: Patients with diagnoses associated with a high number of somatic complaints have a high correlation with reported allergy number. This potentially leads to inferior treatment of a true infection due to limits imposed on antibiotic choice based on allergy history. Careful determination of whether a reported allergy is a true allergy is needed to improve treatment in these patients. 529 Hypersensitivity To Nonsteroidal Antiinflammatories: Immediate Selective Reactions to Arylpropionic Acids In A Population In Madrid Marcos Sanchez-Dominguez, Ana Rodriguez-Fernandez, Ines Torrado, Blanca Noguerado-Mellado, and Patricia Rojas-Perez-Ezquerra; Hospital General Universitario Gregorio Mara~non, Madrid, Spain. RATIONALE: Allergy reactions due to Nonsteroidal anti-inflammatory drugs (NSAIDs), are one of the main causes of drugs hypersensitivity. The aim of the study was to assess the sensitization profile of immediate reactions to arylpropionic acids in our population. METHODS: We performed an observational retrospective study, including all patients attended in our Allergy Unit from May 2008 to October 2016. 1038 patients were revised with suspected selective reactions to NSAIDS. In 234 an arylpropionic acid was involved, being 179 immediate reactions. Allergy workout included skin tests and oral challenge test (OCT) with the culprit drug. In all cases we performed an OCT with acetylsalicylic acid (AAS) in order to rule out cross-intolerance. RESULTS: In 154 out of 179 selective immediate reactions, the offending drug was an arylpropionic acid. 104 women (76.88%), mean age of 50.44 years. Drugs more frequently involved were ibuprofen in 113 (73.38%), dexketoprofen in 24 (15.58%) and naproxen in 17 (11.04%). The symptoms were: urticaria 49 (31.82 %), urticaria with angioedema 35 (22.73%), angioedema 27 (17.53%), wheezing 2 (1.3%) and anaphylaxis 41 (26.62%). Skin test were performed only in 38 (for several causes), all with negative result. In 14, OCT was positive confirming diagnosis. 127 were diagnosed by a suggestive clinical history. The OCT with AAS was positive only in one case. CONCLUSIONS: The most frequent arylpropionic acid involved was ibuprofen. The most frequent symptom was urticaria, and anaphylaxis was reported in 26.62%. The OCT is the gold standard for the diagnosis of immediate selective reactions. 530 Development and validation of the parent-reported drug hypersensitivity quality of life questionnaire Nisarat Chantaravisarut, MD1, Thatchai Wirodwanich, MD1, Wipa Jessadapakorn, MD1, Pasuree Sangsupawanich, MD, PhD1, Tippawan Liabsuetrakul, MD, PhD2, and Araya Yuenyongviwat, MD1; 1Allergy and Immunology Division, Department of Pediatrics, Prince of Songkla University, Songkhla, Thailand, 2Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand. RATIONALE: Drug hypersensitivity in children impact on quality of life over the patients and their caregivers. Measurement quality of life in children is different from adult because the children can’t answer the question by themselves. The research aims to developed and validated the Parent-reported Drug Hypersensitivity Quality of Life Questionnaire (PDrHy-Q) METHODS: At first, the 21-item scale was generated by researchers. Then, the scale was asked for opinion from 3 expert opinion. After adjusted in contents and language the scale was answered by caregivers (N597). Then, factor analysis was carried out selecting the items from the final scale and Croncach’s alpha assessed internal consistency. Finally the test-retest reliability was done in another group of caregivers (N510). RESULTS: The 21-item scale could grouping to 6 factors. However, the inappropriated in some factor, therefore, the reducing factor and item was done by statistical analysis. The final 12-item scale included two factors: mental health and social activity. The scale had a good internal consistency (Cronbach’s a 5 0.897) and the test-retest associations were good (R5 0.9439; P < 0.001) CONCLUSIONS: P-DrHy-Q is the first scale for assessment of the interaction of biopsychosocial factors on drug allergy that includes the dyad carer-child. It show good internal consistency and reliability. Its application might be relevant for future research, and it can provide the clinician and the researcher with a solid tool to define which type of psychosocial support is required to provide a more comprehensive care in drug hypersensitivity. SUNDAY 528A