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Article Abstract
Purpose Of Review: Beta-lactam allergy is frequently reported, but only a minority of cases correspond to true allergies. Tools to stratify the risk of a real allergic reaction can possibly help delabeling patients. We aimed to retrieve evidence on algorithms for risk stratification of patients with a beta-lactam allergy label.
Recent Findings: We performed a systematic review, searching three databases and included 28 studies. Most of the applied tools involved the assessment of the presence of rash/hives/other exanthemas ( n = 24), angioedema/localized swelling ( n = 23), bronchospasm/wheezing/dyspnea ( n = 22) and gastrointestinal symptoms ( n = 21). Seventeen studies classified participants into different categories according to their risk of having a penicillin allergy; three studies presented algorithms indicating management approaches to be followed; six studies applied predictive models. Most studies had a high risk of bias, particularly concerning the reference standard and lack of external validation.
Summary: Existing algorithms for beta-lactam allergy risk stratification are very heterogeneous and most of them lack validation.
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