Allergic reactions due to concomitant administration of multiple drugs in intravenous fluid in emergency departments in Turkey


Submitted: 11 May 2021
Accepted: 16 August 2021
Published: 21 September 2021
Abstract Views: 618
PDF: 253
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

  • Mehmet Erdem Çakmak Clinic of Allergy and Clinical Immunology, Başakşehir Çam ve Sakura City Hospital, Istanbul, Turkey.
  • Saltuk Buğra Kaya Clinic of Allergy and Clinical Immunology, Erzurum Training and Research Hospital, Erzurum, Turkey.
  • Özge Can Bostan Department of Chest Diseases, Division of Allergy and Clinical Immunology, Hacettepe University School of Medicine, Ankara, Turkey.
  • Ebru Damadoğlu Department of Chest Diseases, Division of Allergy and Clinical Immunology, Hacettepe University School of Medicine, Ankara, Turkey.
  • Gül Karakaya Department of Chest Diseases, Division of Allergy and Clinical Immunology, Hacettepe University School of Medicine, Ankara, Turkey.
  • Ali Fuat Kalyoncu Department of Chest Diseases, Division of Allergy and Clinical Immunology, Hacettepe University School of Medicine, Ankara, Turkey.

The present study aimed to evaluate patients who were referred to adult allergy clinic due to allergic reactions after concomitant multiple intravenous-drug administrations in Emergency Department (ED). Between January 2017 and January 2019, patients admitted to our allergy clinic with hypersensitivity reactions to intravenous drugs administered in ED were included retrospectively. Fifty-seven patients who developed allergic reactions after intravenous drug administration in EDs were evaluated. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) were the most common cause of allergic reactions (n = 40, 70.2%). Skin Prick Tests (SPT) were positive in 6 (10.5%) patients. Drug Provocation Tests (DPT) were positive in 10 (17.5%) patients. No significant correlation was found between the total number of drugs in the intravenous fluid and the degree of allergic reaction (r = -0.145, p = 0.282). There was no statistically significant difference between the degree of allergic reaction and history of atopic disease (p = 0.579). In conclusion, concomitant administration of multiple drugs in intravenous fluids may increase the risk of allergic reactions.


Polat O, Kabaçam G, Güler İ, et al. Surveillance analysis of the patients attended to Ibni Sina Hospital Emergency Department. Turk J Emerg Med 2005;5:78-81.

Ersel M, Karcıoğlu Ö, Yanturalı S, et al. Emergency Department utilization characteristics and evaluation for patient visit appropriateness from the patients’ and physicians’ point of view. Turk J Emerg Med 2006;6:25-35.

Pines JM, Pilgrim RL, Schneider SM, et al. Practical implications of implementing emergency department crowding interventions: summary of a moderated panel. Acad Emerg Med 2011;18:1278-82. DOI: https://doi.org/10.1111/j.1553-2712.2011.01227.x

Aboagye-Sarfo P, Mai Q, Sanfilippo FM, et al. Growth in Western Australian emergency department demand during 2007–2013 is due to people with urgent and complex care needs. Emerg Med Australas 2015;27:202-9. DOI: https://doi.org/10.1111/1742-6723.12396

Cowling TE, Harris MJ, Watt HC, et al. Access to general practice and visits to accident and emergency departments in England: cross-sectionalanalysis of a national patient survey. Br J Gen Pract 2014;64:e434-9. DOI: https://doi.org/10.3399/bjgp14X680533

He J, Hou X, Toloo S, et al. Demand for hospital emergency departments: a conceptual understanding. World J Emerg Med 2011;2:253-61. DOI: https://doi.org/10.5847/wjem.j.1920-8642.2011.04.002

Lowthian JA, Curtis AJ, Cameron PA, et al. Systematic review of trends in emergency department attendances: an Australian perspective. Emerg Med J 2011;28:373-7. DOI: https://doi.org/10.1136/emj.2010.099226

Tatli O, Simsek P, Gursoy A, et al. How ımportant is ıntravenous fluid administration to patients presenting to the emergency department and to their families? Eurasian J Emerg Med 2018;17:65-70. DOI: https://doi.org/10.5152/eajem.2017.83803

Gomes ER, Kuyucu S. Epidemiology and Risk Factors in Drug Hypersensitivity Reactions. Curr Treat Options Allergy 2017;4:239-57. DOI: https://doi.org/10.1007/s40521-017-0128-2

Celik GE, Karakaya G, Oztürk AB, et al. Drug allergy in tertiary care in Turkey: Results of a national survey. The ADAPT study: Adult drug allergy perception in Turkey. Allergol Immunopathol 2014;42:573-79. DOI: https://doi.org/10.1016/j.aller.2013.07.007

Gamboa PM. The epidemiology of drug allergy-related consultations in Spanish Allergology services: Alergológica-2005. J Investig Allergol Clin Immunol 2009;19:45-50.

Rueff F, Przybilla B, Bilo MB, et al. Predictors of severe systemic anaphylactic reactions in patients with Hymenoptera venom allergy: importance of baseline serum tryptase a study of the European Academy of Allergology and Clinical Immunology Interest Group on Insect Venom Hypersensitivity. J Allergy Clin Immunol 2009;124:1047-54. DOI: https://doi.org/10.1016/j.jaci.2009.08.027

Adkinson, NF Jr. Risk factors for drug allergy. J Allergy Clin Immunol 1984;74:567-72. DOI: https://doi.org/10.1016/0091-6749(84)90108-8

Tanrıkulu CŞ, Tanrıkul Y, Karaman S. Review of the patients hospitalized from the emergency service and applying to the emergency service: a cross-sectional analysis of a training hospital. J Clin Anal Med 2014;5:128-32. DOI: https://doi.org/10.4328/JCAM.1233

Kılıçaslan İ, Bozan H, Oktay C, Göksu E. Demographic properties of patients presenting to the emergency department in Turkey. Turk J Emerg Med 2005;5:5-13.

Demoly P, Bousquet J. Epidemiology of drug allergy. Curr Opin Allergy Clin Immunol 2001;1:305-10. DOI: https://doi.org/10.1097/01.all.0000011031.16814.e0

Warrington R, Silviu-Dan F, Wong T. Drug allergy. Allergy Asthma Clin Immunol 2018;14:60. DOI: https://doi.org/10.1186/s13223-018-0289-y

Zagursky RJ, Pichichero ME. Cross-reactivity in beta-Lactam Allergy. J Allergy Clin Immunol Pract 2018;6:72-81.e1. DOI: https://doi.org/10.1016/j.jaip.2017.08.027

Weiss ME, Adkinson NF. Diagnostic testing for drug hypersensitivity. Immunol Allergy Clin N Am 1998;18:731-44. DOI: https://doi.org/10.1016/S0889-8561(05)70035-7

Aberer W, Kränke B. Provocation tests in drug hypersensitivity. Immunol Allergy Clin N Am 2009;29:567-84. DOI: https://doi.org/10.1016/j.iac.2009.04.008

Çakmak, M. E., Kaya, S. B., Can Bostan, Özge, Damadoğlu, E., Karakaya, G., & Kalyoncu, A. F. (2021). Allergic reactions due to concomitant administration of multiple drugs in intravenous fluid in emergency departments in Turkey. Emergency Care Journal, 17(3). https://doi.org/10.4081/ecj.2021.9848

Downloads

Download data is not yet available.

Citations