July 22, 2016

Drug allergy passport and other documentation for patients with drug hypersensitivity – An ENDA/EAACI Drug Allergy Interest Group Position Paper

Allergy

  1. K. Brockow1,*
  2. W. Aberer2
  3. M. Atanaskovic-Markovic3
  4. S. Bavbek4
  5. A. Bircher5
  6. B. Bilo6
  7. M. Blanca7
  8. P. Bonadonna8
  9. G. Burbach9
  10. G. Calogiuri10
  11. C. Caruso11
  12. G. Celik12
  13. J. Cernadas13
  14. A Chiriac14
  15. P. Demoly14
  16. J.N.G. Oude Elberink15
  17. J. Fernandez16
  18. E. Gomes17
  19. L. H. Garvey18,
  20. J. Gooi19
  21. M. Gotua20
  22. M. Grosber1
  23. P. Kauppi21
  24. V. Kvedariene22
  25. J. J. Laguna23,
  26. J. Makoswska24
  27. H. Mosbech18
  28. A. Nakonechna25
  29. N. G. Papadopolous26
  30. J. Ring1
  31. A. Romano11,27
  32. H. Rockmann28,
  33. R. Sargur29
  34. L. Sedlackova30
  35. S. Sigurdardottir31
  36. B. Schnyder32
  37. T. Storaas33
  38. M. Torres7
  39. M. Zidarn34 and
  40. I. Terreehorst35
  41. Summary

    The strongest and best-documented risk factor for drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to drugs to may lead to severe or even fatal reactions in sensitised patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a drug allergy passport as well as general guidelines of drug allergy documentation.
    A drug allergy passport, a drug allergy alert card, a certificate and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A drug allergy passport should at least contain information on the culprit drug(s) including international non-proprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative drugs to prescribe and where more detailed information can be obtained from the issuer. It should be given to patients only after full allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.

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