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Sobrino-García M, Muñoz-Bellido FJ, Moreno-Rodilla E, Martín-Muñoz R, García-Iglesias A, Dávila I. Delabeling of allergy to beta-lactam antibiotics in hospitalized patients: a prospective study evaluating cost savings. Int J Clin Pharm 2024:10.1007/s11096-024-01737-7. [PMID: 38642250 DOI: 10.1007/s11096-024-01737-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Patients with a penicillin allergy label are at risk of an associated increase in adverse antibiotic events and hospitalization costs. AIM We aimed to study the economic savings derived from the correct diagnosis and delabeling inpatients with suspected beta-lactam allergy, considering the acquisition cost of antimicrobials prescribed during a patient's hospital stay. METHOD We prospectively evaluated patients admitted to the University Hospital of Salamanca who had been labeled as allergic to beta-lactams and performed a delabeling study. Subsequently, cost differences between antibiotics administered before and after the allergy study and those derived from those patients who received alternative antibiotics during admission and those who switched to beta-lactams after the allergy study were calculated. RESULTS One hundred seventy-seven inpatients labeled as allergic to beta-lactams underwent a delabeling study; 34 (19.2%) were confirmed to have allergy to beta-lactams. Of the total number of patients, 136 (76.8%) received antibiotics during their hospitalization, involving a mean (SD) cost of €203.07 (318.42) and a median (IQR) cost of €88.97 (48.86-233.56). After delabeling in 85 (62.5%) patients, the antibiotic treatment was changed to beta-lactams. In this group of patients, the mean cost (SD) decreased from €188.91 (351.09) before the change to 91.31 (136.07) afterward, and the median cost (IQR) decreased from €72.92 (45.82-211.99) to €19.24 (11.66-168). The reduction was significant compared to the median cost of patients whose treatment was not changed to beta-lactams (p<0.001). CONCLUSION Delabeling hospitalized patients represents a cost-saving measure for treating patients labeled as allergic to beta-lactams.
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Affiliation(s)
- Miriam Sobrino-García
- Allergy Service, University Hospital of Salamanca, Salamanca, Castilla y León, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Castilla y León, Spain
| | - Francisco J Muñoz-Bellido
- Allergy Service, University Hospital of Salamanca, Salamanca, Castilla y León, Spain.
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Castilla y León, Spain.
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Castilla y León, Spain.
- Red de Enfermedades Inflamatorias - Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain.
- Servicio de Alergología, Hospital Universitario de Salamanca, Paseo de La Transición Española, 37007, Salamanca, Spain.
| | - Esther Moreno-Rodilla
- Allergy Service, University Hospital of Salamanca, Salamanca, Castilla y León, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Castilla y León, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Castilla y León, Spain
- Red de Enfermedades Inflamatorias - Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Rita Martín-Muñoz
- Hospital Pharmacy Service, University Hospital of Salamanca, Salamanca, Castilla y León, Spain
| | - Aránzazu García-Iglesias
- Admission and Clinical Documentation Service, University Hospital of Salamanca, Salamanca, Castilla y León, Spain
| | - Ignacio Dávila
- Allergy Service, University Hospital of Salamanca, Salamanca, Castilla y León, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Castilla y León, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Castilla y León, Spain
- Red de Enfermedades Inflamatorias - Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
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Monsalve RI, Lombardero M, Christensen LH, Núñez-Acevedo B, González-de-Olano D, Sobrino-García M, Castillo-Loja RM, Bravo SB, Alonso-Sampedro M, Vidal C. Structural Similarities, in Relation with the Cross-Reactivity, of Hymenoptera Allergenic Dipeptidyl Peptidases IV-An Overall Comparison Including a New Dipeptidyl Peptidase IV Sequence from Vespa velutina. Toxins (Basel) 2023; 15:656. [PMID: 37999519 PMCID: PMC10675595 DOI: 10.3390/toxins15110656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/31/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
(1) Background: Dipeptidyl Peptidases IV (DPPIVs), present in many organisms, are minor components in the venoms of Hymenoptera, where they have been identified as cross-reactive allergenic molecules. Considering that the structure of homologous DPPIVs is well characterized, we aimed to explain which regions have higher similarity among these proteins and present a comparison among them, including a new Vespa velutina DPPIV sequence. Moreover, two cases of sensitization to DPPIVs in wasp- and honeybee-sensitized patients are presented. (2) Methods: Proteomic analyses have been performed on the venom of the Asian hornet Vespa velutina to demonstrate the sequence of its DPPIV (allergen named Vesp v 3, with sequence accession number P0DRB8, and with the proteomic data available via ProteomeXchange with the identifier PXD046030). A comparison performed through their alignments and analysis of the three-dimensional structure showed a region with higher similarity among Hymenoptera DPPIVs. Additionally, ImmunoCAP™ determinations (including specific inhibition experiments), as well as IgE immunoblotting, are performed to demonstrate the allergenicity of Api m 5 and Ves v 3. (3) Results and Conclusions: The data presented demonstrate that the similarities among Hymenoptera DPPIVs are most likely localized at the C-terminal region of these enzymes. In addition, a higher similarity of the Vespa/Vespula DPPIVs is shown. The clinical cases analyzed demonstrated the allergenicity of Api m 5 and Ves v 3 in the sera of the allergic patients, as well as the presence of this minor component in the preparations used in venom immunotherapy.
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Affiliation(s)
| | | | | | - Beatriz Núñez-Acevedo
- Allergology Service, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, 28702 Madrid, Spain;
| | - David González-de-Olano
- Allergy Service, Hospital Ramón y Cajal, IRYCIS (Instituto Ramón y Cajal de Investigación Sanitaria), 28034 Madrid, Spain;
| | | | - Rosita M. Castillo-Loja
- Biosanitary Institute, IBSAL (Instituto de Investigación Biomédica de Salamanca), 37007 Salamanca, Spain;
| | - Susana B. Bravo
- Proteomic Unit, Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | - Manuela Alonso-Sampedro
- Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS), Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS-ISCIII/RD21/0016/0022), University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | - Carmen Vidal
- Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS), Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS-ISCIII/RD21/0016/0022), University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain;
- Allergy Department, University Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain;
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3
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Sobrino-García M, Muñoz-Bellido FJ, Moreno E, Gracia-Bara MT, Laffond E, Lázaro-Sastre M, Martín-García C, Dávila I. A prospective study of costs associated with the evaluation of allergic reactions to radiological contrast media. J Investig Allergol Clin Immunol 2022; 33:102-108. [PMID: 35029155 DOI: 10.18176/jiaci.0774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The prevalence of hypersensitivity reactions to radiological contrast media (RCM) is increasing due to the greater performance of diagnostic and therapeutic tests that require RCMs. Objective: We carried out a year-long real-life observational study to prospectively evaluate the patients referred to the Allergy Service from Primary Care, Emergency Room, and other Services with suspected moderate to severe RCM hypersensitivity. METHODS To study the costs of RCM hypersensitivity evaluation, we systematically recorded direct and indirect costs. RESULTS Sixty-nine patients with previous reactions to RCM were evaluated in the Allergy Service from June 1st, 2017, to May 31st, 2018. Total direct health care costs were € 10715.84, with a mean cost per patient of € 155.30 ± 77.08. Specifically, direct non-health costs reached € 1605.42 (mean € 23.27 ± 41.14), and indirect costs were € 6490.85 (mean € 94.07 ± 110.61). In summary, the total cost was € 18812.11, which means a mean cost of € 272.64 ± 164.77. CONCLUSION Our study reflects that the costs of an elective evaluation of hypersensitivity to RCM are low. This fact reaffirms that correct and safe management of these patients could be cost-effective, so our efforts should be directed to implement the necessary logistics.
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Affiliation(s)
- M Sobrino-García
- Allergy Service, University Hospital of Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain
| | - F J Muñoz-Bellido
- Allergy Service, University Hospital of Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences. Faculty of Medicine. University of Salamanca, Spain
| | - E Moreno
- Allergy Service, University Hospital of Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences. Faculty of Medicine. University of Salamanca, Spain.,Asthma, Allergic and Adverse Reactions (ARADyAL) Network for Cooperative Research in Health of Instituto de Salud Carlos III, Salamanca University Hospital, Salamanca, Spain
| | - M T Gracia-Bara
- Allergy Service, University Hospital of Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain
| | - E Laffond
- Allergy Service, University Hospital of Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences. Faculty of Medicine. University of Salamanca, Spain
| | - M Lázaro-Sastre
- Allergy Service, University Hospital of Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain
| | - C Martín-García
- Allergy Service, University Hospital of Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain
| | - I Dávila
- Allergy Service, University Hospital of Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences. Faculty of Medicine. University of Salamanca, Spain.,Asthma, Allergic and Adverse Reactions (ARADyAL) Network for Cooperative Research in Health of Instituto de Salud Carlos III, Salamanca University Hospital, Salamanca, Spain
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Macías-Iglesias EM, Campanón-Toro MV, Moreno-Rodilla E, de Arriba-Méndez S, Sobrino-García M, Gallardo-Higueras A, Dávila González I. DRESS syndrome with gadolinium contrast media in a 13-year-old boy. J Investig Allergol Clin Immunol 2021; 32:238-240. [PMID: 34661534 DOI: 10.18176/jiaci.0742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - E Moreno-Rodilla
- Allergy Department, University Hospital of Salamanca-IBSAL, Spain. Asthma, Allergic and Adverse Reactions (ARADyAL) Network for Cooperative Research in Health of Instituto de Salud Carlos III, Salamanca University Hospital, Salamanca, Spain
| | | | - M Sobrino-García
- Allergy Department, University Hospital of Salamanca-IBSAL, Spain
| | | | - I Dávila González
- Allergy Department, University Hospital of Salamanca-IBSAL, Spain. Asthma, Allergic and Adverse Reactions (ARADyAL) Network for Cooperative Research in Health of Instituto de Salud Carlos III, Salamanca University Hospital, Salamanca, Spain
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5
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Sobrino-García M, Moreno EM, Muñoz-Bellido FJ, Gracia-Bara MT, Laffond E, Doña I, Martín C, Macías EM, de Arriba S, Campanón V, Gallardo A, Dávila I. Analysis of the Costs Associated With the Elective Evaluation of Patients Labelled as Allergic to Beta-Lactams or Nonsteroidal Antiinflamatory Agents. Front Pharmacol 2020; 11:584633. [PMID: 33746738 PMCID: PMC7970755 DOI: 10.3389/fphar.2020.584633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/14/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Being labelled as allergic to different drugs results in patients receiving other treatments, which are more toxic, less effective and more expensive. We aimed to analyze different studies of the costs of drug hypersensitivity assessment. Methods: A bibliographic search on studies regarding this issue was performed, including the available scientific evidence up to June 2020. We searched three databases with terms related to costs and allergy testing in drug hypersensitivity reactions. Results: Our search revealed 1,430 publications, of which 20 met the inclusion criteria. In the manuscript, prospective studies evaluating the costs of the evaluation of patients with suspected allergy to beta-lactams or non-steroidal anti-inflammatory drugs are analyzed. Also, comment is made on the costs associated with incorrect labeling as non-steroidal anti-inflammatory drug or penicillin hypersensitivity. Conclusions: Taking all costs into account, the study of drug hypersensitivity is not expensive, particularly considering the economic and clinical consequences of labeling a patient with hypersensitivity to drugs.
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Affiliation(s)
| | - Esther M Moreno
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain.,Asthma, Allergic and Adverse Reactions (ARADyAL), Network for Cooperative Research in Health of Instituto de Salud Carlos III, Salamanca University Hospital, Salamanca, Spain
| | - Francisco J Muñoz-Bellido
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Maria T Gracia-Bara
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Elena Laffond
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Inmaculada Doña
- Asthma, Allergic and Adverse Reactions (ARADyAL), Network for Cooperative Research in Health of Instituto de Salud Carlos III, Salamanca University Hospital, Salamanca, Spain.,Allergy Service, University Hospital of Malaga, Malaga, Spain.,Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
| | - Cristina Martín
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Eva M Macías
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Sonia de Arriba
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Valle Campanón
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain
| | - Alicia Gallardo
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain
| | - Ignacio Dávila
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain.,Asthma, Allergic and Adverse Reactions (ARADyAL), Network for Cooperative Research in Health of Instituto de Salud Carlos III, Salamanca University Hospital, Salamanca, Spain
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6
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Sobrino-García M, Muñoz-Bellido FJ, Moreno E, Macías E, Gracia-Bara MT, Laffond E, Lázaro-Sastre M, Martín-García C, de Arriba-Méndez S, Campanón-Toro MV, Gallardo-Higueras A, Dávila I. A Comprehensive Prospective Study of the Costs Associated With Evaluation of ß-Lactam Allergy. J Investig Allergol Clin Immunol 2019; 31:52-57. [PMID: 31599727 DOI: 10.18176/jiaci.0457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Being labeled as allergic to penicillin (unverified ß-lactam allergy) can result in patients receiving broader-spectrum antibiotics than necessary that may be more toxic, less effective, and/or more expensive than alternative options. Objective: We aimed to evaluate the real costs of evaluating ß-lactam allergy. METHODS We performed a prospective real-life observational study designed to evaluate all adult patients who consulted for suspected ß-lactam allergy over a 1-year period. Direct and indirect costs were systematically recorded. Direct health costs were calculated based on the number of visits and all additional and diagnostic tests performed, direct nonhealth costs based on the number of visits and the distance from their homes to the Allergy Department, and indirect costs based on absenteeism. RESULTS A total of 296 patients with suspected allergy to ß-lactams were evaluated in our outpatient clinic from June 1, 2017 to May 31, 2018. Total direct health care costs were €28 176.70, with a mean (SD) cost of €95.19 (37.20). Direct nonhealth costs reached €6551.73, that is, €22.13 (40.44) per patient. Indirect health costs reached €20 769.20, with a mean of €70.17 (127.40). In summary, the total cost was €55 497.63, that is, a cost per patient of €187.49 (148.14). CONCLUSIONS When all possible costs are taken into account, the evaluation of ß-lactam allergy is not expensive and can reduce future expense arising from unnecessary use of more expensive and less effective antibiotics.
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Affiliation(s)
- M Sobrino-García
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain
| | - F J Muñoz-Bellido
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - E Moreno
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain.,Asthma, Allergic and Adverse Reactions (ARADyAL) Network for Cooperative Research in Health of Instituto de Salud Carlos III, Salamanca University Hospital, Salamanca, Spain
| | - E Macías
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - M T Gracia-Bara
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain
| | - E Laffond
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - M Lázaro-Sastre
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain
| | - C Martín-García
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain
| | - S de Arriba-Méndez
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | | | | | - I Dávila
- Allergy Service, University Hospital of Salamanca, Salamanca, Spain.,Institute for Biomedical Research of Salamanca, IBSAL, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Salamanca, Spain.,Asthma, Allergic and Adverse Reactions (ARADyAL) Network for Cooperative Research in Health of Instituto de Salud Carlos III, Salamanca University Hospital, Salamanca, Spain
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7
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Sobrino-García M, Gómez-Cardeñosa A, Moreno-Rodilla E, Muñoz-Bellido FJ, Lázaro-Sastre M, Dávila I. A case report of fixed drug eruption caused by several drugs because of cross-reactivity and co-sensitization. Contact Dermatitis 2018; 80:56-57. [DOI: 10.1111/cod.13115] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 07/30/2018] [Accepted: 08/07/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Miriam Sobrino-García
- Department of Allergy; University Hospital of Salamanca; Salamanca Spain
- Institute for Biomedical Research of Salamanca, IBSAL; Salamanca Spain
| | | | - Esther Moreno-Rodilla
- Department of Allergy; University Hospital of Salamanca; Salamanca Spain
- Institute for Biomedical Research of Salamanca, IBSAL; Salamanca Spain
- Department of Biomedical and Diagnostic Sciences; University of Salamanca; Salamanca Spain
| | - Francisco J. Muñoz-Bellido
- Department of Allergy; University Hospital of Salamanca; Salamanca Spain
- Institute for Biomedical Research of Salamanca, IBSAL; Salamanca Spain
- Department of Biomedical and Diagnostic Sciences; University of Salamanca; Salamanca Spain
| | - Milagros Lázaro-Sastre
- Department of Allergy; University Hospital of Salamanca; Salamanca Spain
- Institute for Biomedical Research of Salamanca, IBSAL; Salamanca Spain
- Department of Biomedical and Diagnostic Sciences; University of Salamanca; Salamanca Spain
| | - Ignacio Dávila
- Department of Allergy; University Hospital of Salamanca; Salamanca Spain
- Institute for Biomedical Research of Salamanca, IBSAL; Salamanca Spain
- Department of Biomedical and Diagnostic Sciences; University of Salamanca; Salamanca Spain
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8
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Campanón-Toro MV, Sierra O, Moreno E, Sobrino-García M, Gracia-Bara MT, Dávila I. Acute generalized exanthematous pustulosis (AGEP) induced by azithromycin. Contact Dermatitis 2017; 76:363-364. [DOI: 10.1111/cod.12717] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/16/2016] [Accepted: 09/21/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | - Omar Sierra
- Allergy Department; University Hospital of Salamanca; 37007 Salamanca Spain
| | - Esther Moreno
- Allergy Department; University Hospital of Salamanca; 37007 Salamanca Spain
- IBSAL (Instituto Biosanitario de Salamanca); University Hospital of Salamanca; Spain
- Department of Biomedical and Diagnostic Sciences, Salamanca Medical School; University of Salamanca; Spain
| | | | - Maria T. Gracia-Bara
- Allergy Department; University Hospital of Salamanca; 37007 Salamanca Spain
- IBSAL (Instituto Biosanitario de Salamanca); University Hospital of Salamanca; Spain
| | - Ignacio Dávila
- Allergy Department; University Hospital of Salamanca; 37007 Salamanca Spain
- IBSAL (Instituto Biosanitario de Salamanca); University Hospital of Salamanca; Spain
- Department of Biomedical and Diagnostic Sciences, Salamanca Medical School; University of Salamanca; Spain
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