Evidence map›Paper›PMID 37021506›Full record

ArticleAllergy, asthma & immunology research2023

Clavulanic Acid Is a Leading Culprit Beta-Lactam in Immediate Allergic Reactions to Penicillins.

Isabel Torres-Rojas, Diana Pérez-Alzate, Maria Luisa Somoza, Ana Prieto-Moreno Pfeifer, Elisa Haroun Diaz, Teodorikez W Jimenez-Rodriguez, Javier Fernández Sánchez, Francisco J Ruano, Miguel Blanca, Natalia Blanca-López

Open access · diamondAbstract read
In one paragraph

Article in Allergy, asthma & immunology research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Isabel Torres-RojasAllergy Unit, Infanta Leonor University Hospital, Madrid, Spain.ORCID https://orcid.org/0000-0002-4030-8240
Diana Pérez-AlzateAllergy Unit, Infanta Leonor University Hospital, Madrid, Spain.
Maria Luisa SomozaAllergy Unit, Infanta Leonor University Hospital, Madrid, Spain.ORCID https://orcid.org/0000-0002-0141-8914
Ana Prieto-Moreno PfeiferAllergy Unit, Infanta Leonor University Hospital, Madrid, Spain.ORCID https://orcid.org/0000-0003-4456-6615
Elisa Haroun DiazAllergy Unit, Infanta Leonor University Hospital, Madrid, Spain.ORCID https://orcid.org/0000-0001-7307-9758
Teodorikez W Jimenez-RodriguezAllergy Unit, Alicante General University Hospital-ISABIAL, Alicante, Spain.ORCID https://orcid.org/0000-0002-4341-0507
Javier Fernández SánchezAllergy Unit, Alicante General University Hospital-ISABIAL, Alicante, Spain.ORCID https://orcid.org/0000-0003-1065-7199
Francisco J RuanoAllergy Unit, Infanta Leonor University Hospital, Madrid, Spain.ORCID https://orcid.org/0000-0003-4098-3446
Miguel BlancaIndependent Investigator-Advisor, Madrid, Spain.
Natalia Blanca-LópezAllergy Unit, Infanta Leonor University Hospital, Madrid, Spain. natalia.blanca@gmail.com.ORCID https://orcid.org/0000-0002-1492-9887
Hospital Universitario Infanta Leonor · ESHospital General Universitario de Alicante Doctor Balmis · ESIndependent Sector · US

Funding

FEDER funds RD16/0006/0024FEDER funds RD16/0006/0032Instituto de Salud Carlos III PI20/00771
6 · The paper itself

Abstract

purposeClavulanate, a beta-lactam associated with amoxicillin, is frequently prescribed in patients at all ages. Recent data implicate amoxicillin-clavulanate in up to 80% of beta-lactam allergy cases. We assessed clavulanate's role in inducing allergic reactions to this combination treatment, with a focus on selective immediate reactions.

methodsAdults (≥ 16 years) reporting a history of immediate reactions to amoxicillin-clavulanate were evaluated through a beta-lactam allergological workup, using modified European Academy of Allergy and Clinical Immunology guidelines. Patients first underwent skin testing, and if negative, drug provocation tests. Expected outcomes were: Group A, subjects with immediate reaction to classical penicillin group determinants (penicilloyl polylysine, minor determinants mixture, and/or penicillin G); Group B, subjects with selective immediate reaction to amoxicillin; Group C, subjects with selective immediate reaction to clavulanate and Group D, those immediate reactions with co-sensitization to clavulanate plus penicillin group determinants or amoxicillin.

resultsOf 1,170 included patients, 104 had immediate reactions: 36.5% to penicillin group determinants (Group A), 26.9% to amoxicillin (Group B), 32.7% to clavulanate (Group C), and 3.8% to clavulanate plus penicillin determinants or amoxicillin (Group D). Diagnosis was made by skin testing in 79%, 75% and 47% of the patients, respectively, in the first 3 groups (

conclusionsSelective immediate reactions to clavulanate accounted for over a third of cases with confirmed reactions after amoxicillin-clavulanate intake, with more than half experiencing anaphylaxis. Within this group, skin test sensitivity was below 50%. People taking amoxicillin-clavulanate may also be co-sensitized to both drugs.

Indexed as

amoxicillin, clavulanicbeta-lactamsDrug hypersensitivityimmediate

Identifiers

PMID37021506
PMCPMC10079519
OpenAlexW4362592158

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.