Beta-lactam Allergies Among Solid Organ Transplant Recipients: Prevalence and Association with Transplant Admission Length of Stay
N. N. Pettit1, V. Nguyen2, C. T. Nguyen1, A. Lew1, J. Pisano1, L. M. Potter1
1University of Chicago Medicine, Chicago, IL, 2University of Michigan College of Pharmacy, Ann Arbor, MI
Meeting: 2021 American Transplant Congress
Abstract number: 755
Keywords: Adverse effects, Infection, Length of stay, Safety
Topic: Clinical Science » Infectious Disease » All Infections (Excluding Kidney & Viral Hepatitis)
Session Information
Session Name: All Infections (Excluding Kidney & Viral Hepatitis)
Session Type: Poster Abstract
Session Date & Time: None. Available on demand.
Location: Virtual
*Purpose: Previous studies have identified that 14-27% of solid organ transplant (SOT) recipients report a beta lactam allergy (BLA). Patients with BLAs often receive less effective and more toxic antibiotics, and often have worse clinical outcomes such as prolonged length of hospital stay. This is of particular concern for patients undergoing SOT given their high risk for developing post-transplant infections, including those caused by multi-drug resistant pathogens, given their frequent exposure to the healthcare setting and antibiotics. We sought to identify the prevalence of BLA among SOT recipients at our medical center and evaluate the impact of BLAs on transplant admission length of stay (LOS).
*Methods: All patients undergoing SOT from 1/1/2017 to 12/31/18 were included in this retrospective review. Baseline characteristics include age, gender, race/ethnicity, and type of transplant. Allergy data included allergen, reaction, and date documented. LOS was calculated based on admit and discharge dates for the transplant admission.
*Results: During the time period, 54 (16.4%) patients had a documented BLA out of a total of 329 patients undergoing a SOT. Table 1 summarizes the baseline characteristics. The prevalence of BLA was 23% in lung (12 of 52), 19% in liver (11 of 58), 15% in kidney (19 of 130), 15% in heart (10 of 65), 17% in pancreas/islet (1 of 6), and 6% in multiorgan recipients (1 of 18). The most common type of reaction was rash (26%), followed by hives/urticaria (22%). Table 2 provides a summary of the reactions documented. The mean LOS among patients with a BLA vs. without was 26.7 days and 33.4 days, respectively.
*Conclusions: Similar to previous studies, we observed an overall prevalence of BLAs among SOT recipients of 16.4%. We did not observe a prolonged transplant admission LOS among those with a BLA vs. without. Further evaluation to assess the impact of BLA labels among SOT recipients on additional outcomes such as antibiotic prescribing, post-transplant readmissions, rates of multi-drug resistant and Clostridioides difficile infections, and mortality is needed.
| BLA (N=54) | Without BLA (N=275) | |
| Age, mean + st dev | 56 + 15 | 51 + 15 |
| Gender, M (%) | 31 (57) | 180 (65) |
| Race/Ethnicity | ||
| Black/African American (%) | 9 (17) | 100 (36) |
| Hispanic/Latino (%) | 2 (4) | 25 (9) |
| White (%) | 41 (76) | 124 (45) |
| Other (%) | 2 (4) | 26 (9) |
| Reaction | Number (%) |
| GI Intolerance | 4 (7) |
| Pruritus | 5 (9) |
| Rash | 14 (26) |
| Anaphylaxis/angioedema | 6 (11) |
| Urticaria/hives | 12 (22) |
| Bronchospasm, SOB, loss of consciousness | 6 (12) |
| Unknown childhood reaction, other | 8 (15) |
To cite this abstract in AMA style:
Pettit NN, Nguyen V, Nguyen CT, Lew A, Pisano J, Potter LM. Beta-lactam Allergies Among Solid Organ Transplant Recipients: Prevalence and Association with Transplant Admission Length of Stay [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/beta-lactam-allergies-among-solid-organ-transplant-recipients-prevalence-and-association-with-transplant-admission-length-of-stay/. Accessed November 21, 2024.« Back to 2021 American Transplant Congress