AUTHOR=Kühl Johanna , Bergh Björn , Laudes Matthias , Szymczak Silke , Heine Guido 

TITLE=Cofactors of drug hypersensitivity—A monocenter retrospective analysis

JOURNAL=Frontiers in Allergy

VOLUME=Volume 3 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2022.1097977

DOI=10.3389/falgy.2022.1097977

ISSN=2673-6101

ABSTRACT=Background: Drug hypersensitivity reactions (DHR) are a major medical problem that influence the treatment of patients by both under- and overdiagnosis. Still, little is known about the role of predisposing or protecting cofactors of DHR.
Objective: To determine drug-specific cofactors in patients with DHR.
Methods: Retrospective file chart analysis between 2015-2020 from inpatients with suspected DHR in our department. Descriptive statistics and a multiple logistic regression model for the estimation and statistical interference.
Results: DHR were suspected in 393 patients with 678 culprit drugs. In 183 cases drug hypersensitivities were confirmed, mostly against non-opioid analgesic drugs and antibiotics. Multiple logistic regression analysis identified a positive association of antibiotic hypersensitivity with obesity (OR 5.75, average marginal effect (AME) +24.4%), age and a negative with arterial hypertension, female sex, elevated IgE and allergic rhinitis. A hypersensitivity to non-opioid analgesics was associated with atopic dermatitis (OR 10.28, AME +28.5%), elevated IgE, and arterial hypertension.
Conclusions: Drug-specific cofactors of DHR include obesity for antibiotics and atopic dermatitis for non-opioid analgesics, the knowledge of which may improve the risk calculation for drug provocation tests.