Background Studies have shown the discrepancy between self-reported antibiotic allergies and true allergies. Inaccurate reporting of antibiotic hypersensitivities can limit treatment options and result in use of more expensive antibiotics and contribute to resistance. Methods This retrospective cohort chart review obtained data on 16,515 patients after obtaining IRB approval. Patients who had an antibiotic adverse reaction were identified, recorded, and their management reviewed. 7926 patients were selected from inpatient internal medicine clinics, 8042 patients from outpatient internal medicine clinics, and 547 from orthopedic clinics. Results The prevalence of reported antibiotic sensitivity in our study was 9.89% (n = 1624). Reported antibiotic sensitivity was 8.88% (n = 704) in inpatient settings as compared to 11.2% (n = 902) and 5.12% (n = 28) in medicine and orthopedic outpatient settings respectively. The top five antibiotic adverse reactions reported were penicillins (42%), sulfonamides (25%), fluoroquinolones (4.3%), tetracyclines (4.2%), and macrolides (3.5%). In all settings, penicillins and sulfonamides adverse reactions were the top two reportings. 11.88% (n = 193) of patients with reported adverse reactions reported sensitivities to multiple antibiotics. Conclusion Our study demonstrated high prevalence of reported antibiotic sensitivity in three clinical settings. However, a significant portion of these patients may not be truly hypersensitive to these antibiotics. There is a need for increased awareness among medical professionals about the importance of detailed history taking and management of self-reported antibiotic allergies to combat unnecessary use of antibiotics.

中文翻译：

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抗生素超敏反应和不良反应：临床实践中的管理和影响。

背景研究表明，自我报告的抗生素过敏与真正的过敏之间存在差异。抗生素超敏反应的不准确报告可能会限制治疗选择并导致使用更昂贵的抗生素并导致耐药性。方法 该回顾性队列图表审查在获得 IRB 批准后获得了 16,515 名患者的数据。识别、记录发生抗生素不良反应的患者，并对其管理进行审查。内科住院7926例，内科门诊8042例，骨科547例。结果 在我们的研究中报告的抗生素敏感性的患病率为 9.89% (n = 1624)。住院环境中报告的抗生素敏感性为 8.88%（n = 704），而住院环境中的抗生素敏感性为 11.2%（n = 902）和 5。医学和骨科门诊分别为 12% (n = 28)。报告的前五位抗生素不良反应是青霉素（42%）、磺胺类药物（25%）、氟喹诺酮类药物（4.3%）、四环素类药物（4.2%）和大环内酯类药物（3.5%）。在所有情况下，青霉素和磺胺类药物的不良反应是前两项报告。11.88% (n = 193) 报告有不良反应的患者报告对多种抗生素敏感。结论 我们的研究表明，在三种临床环境中报告的抗生素敏感性很高。然而，这些患者中有很大一部分可能对这些抗生素并不真正过敏。