Reply to "Management of Patients with Suspected or Confirmed Antibiotic Allergy"

• Published in: Journal of investigational allergology & clinical immunology Vol. 33; no. 6; pp. 500 - 501
• Main Authors: Barroso, B, Gómez-López, A, Valverde-Monge, M
• Format: Journal Article
• Language: English
• Published: Spain Esmon Publicidad 01-01-2023
• Subjects: Allergies; Anti-Bacterial Agents - adverse effects; Antibiotics; Diarrhea; Drug Hypersensitivity - drug therapy; Drug Hypersensitivity - therapy; Emergency medical care; Enterocolitis; Humans; Hypersensitivity - drug therapy; Hypotension; Hypothermia; Renal failure; Vomiting; Antibiotic allergy; Drug hypersensitivity reaction; Drug-mediated enterocolitis syndrome (DIES); Drug allergy
• ISSN: 1018-9068; 1698-0808
• DOI: 10.18176/jiaci.0901

The authors of this letter respond to an article on the management of patients with suspected or confirmed antibiotic allergies. They specifically address section 3.2.2 of the article, which suggests that patients with self-reported antibiotic allergies and symptoms such as vomiting or diarrhea can be delabeled without further specialized evaluation or testing. The authors argue that this categorical indication excludes cases of drug-induced enterocolitis syndrome (DIES), a rare non-IgE-mediated drug hypersensitivity with isolated digestive involvement. They highlight the criteria for diagnosing DIES, which includes vomiting, lethargy, pallor, emergency department visits, diarrhea, hypotension, and hypothermia. The authors emphasize that DIES can be potentially fatal and may cause kidney failure and hypovolemic shock. They recommend that an allergy study should be carried out for patients reporting vomiting or diarrhea that meet the criteria for DIES. The authors also discuss the prevalence, pathophysiology, and treatment of DIES. They conclude by emphasizing the need for greater attention, recognition, and accurate management of DIES, particularly among professionals working with children.