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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Beta-lactamic antibiotics allergy in cataract surgery. Prevalence and preoperati...
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Vol. 89. Issue 3.
Pages 92-98 (March 2014)
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Vol. 89. Issue 3.
Pages 92-98 (March 2014)
Original article
Beta-lactamic antibiotics allergy in cataract surgery. Prevalence and preoperative characteristics of allergic patients
Alergia a antibióticos β-lactámicos en cirugía de cataratas. Prevalencia y características preoperatorias de los pacientes alérgicos
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M.E. Fernández-Rubioa,
Corresponding author
, T. Cuesta-Rodríguezb, J.L. Urcelay-Segurab, C. Cortés-Valdésb
a Departamento de Oftalmología, Instituto Oftálmico, Laboratorio de Análisis Clínicos, Hospital General Universitario Gregorio Marañón, Madrid, Spain
b Departamento de Oftalmología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Tables (5)
Table 1. Data used for defining patient comorbidity.
Table 2. Prevalence of allergy to β-lactamics in patients operated on for cataracts.
Table 3. Characteristics of β-lactamic antibiotic allergic and nonallergic patients consecutively admitted to first eye cataract surgery from July 11, 2005 to November 13, 2012. Comparison of age and percentages.
Table 4. Conjunctival bacteria prevalence comparison of β-lactamic antibiotics allergic and nonallergic patients consecutively admitted to first cataract surgery from 11 July, 2005 to November 13, 2012.
Table 5. Percentage comparison of the nonfermenting gram-negative bacilli (NFGNB) in β-lactamic antibiotics allergic and nonallergic patients.
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Abstract
Objective

To describe the proportion of patients allergic to β-lactam antibiotics and the prevalence of preoperative conjunctival bacteria among those undergoing cataract surgery in our area.

Method

Retrospective cross-sectional study of prevalence of β-lactam allergic patients consecutively scheduled for cataract surgery from 11 July 2005 to November 2012. For studying the prevalence of conjunctival bacteria and clinical characteristics in the patients’ preoperative examination, those under 18 years and those with cataract surgery combined with other eye surgeries were excluded. Data from the first preoperative examination of the remaining patients were selected. Clinical data were extracted from the database generated in the evaluation made for anesthetic purposes, and the microbiological data from the laboratory database. Both bases were linked through a patient history code. A comparison was made between the prevalence of conjunctival bacteria and clinical characteristics in allergic and non-allergic patients.

Results

From 12,409 adults selected for the bacteriological study, 862 (6.96%) were allergic to β-lactams; their mean age (74.45 years) was higher than those who were non-allergic (p=.005). The proportion of women (71.4%) in the allergic patient group was much higher than that of men. The prevalence of pathogenic bacteria (especially Bacillus spp and Pseudomonas aeruginosa), lung disease and heart failure, was higher in allergic patients.

Conclusions

The prevalence of allergy to β-lactams in this study is within the range described in other populations. The higher prevalence of pathogenic bacteria and the predominance of women in those allergic to β-lactams are useful data to guide their surgical prophylaxis.

Keywords:
Beta-lactams allergy
Allergy prevalence
Cefuroxime allergy
Cataract surgery
Surgery prophylaxis
Intracameral prophylaxis
Asthma prevalence
Resumen
Objetivo

Describir la proporción de pacientes alérgicos a antibióticos β-lactámicos y su flora conjuntival entre los admitidos a cirugía de cataratas en nuestro entorno.

Método

Estudio retrospectivo transversal de prevalencia de pacientes alérgicos a β-lactámicos admitidos consecutivamente a cirugía de cataratas del 11 de julio de 2005 al 13 de noviembre de 2012. Para estudiar la prevalencia de bacterias conjuntivales y de carac-terísticas clínicas en el examen preoperatorio de los pacientes se excluyeron los menores de 18 años y aquellos con operaciones de cataratas combinadas con otras cirugías ocula res, seleccionando los datos del primer preoperatorio de los pacientes restantes. Los datos clínicos se extrajeron de la base de datos generada en la consulta de evaluación para anes tesia, y los microbiológicos de la base de datos del laboratorio. Ambas bases se vincularon mediante el código de historia clínica. Se comparó la prevalencia de bacterias conjuntivales y de características clínicas entre alérgicos y no-alérgicos.

Resultados

De 12.409 adultos seleccionados para estudio bacteriano, 862 (6,96%) eran alér gicos a β-lactámicos, su edad media era de 74,45 años, superior a la de los no-alérgicos (p=0,005). En los alérgicos la proporción de mujeres (71,4%) fue muy superior a la de hom bres. La prevalencia de bacterias patógenas (especialmente Bacillus spp. y Pseudomonas aeruginosa), enfermedades pulmonares e insuficiencia cardiaca fue mayor en los alérgicos.

Conclusiones

La prevalencia de alérgicos a β-lactámicos de este estudio está comprendida en el rango descrito en otras poblaciones. La mayor prevalencia de bacterias patógenas y el predominio de mujeres en los alérgicos a β-lactámicos son datos útiles para pautar su profilaxis quirúrgica.

Palabras clave:
Alergia a β-lactámicos
Prevalencia de alergia
Alergia a cefuroxima
Cirugía de cataratas
Profilaxis quirúrgica
Profilaxis intracameral
Prevalencia del asma

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