Allergy Patterns in a Tertiary Care Referral Center
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Maria A. Barcena Blanch, MD, Julie T. Abraham, MD, David M. Lang, MD FAAAAI
Rationale: We have analyzed contents of the ALLERGY field in our electronic medical record (EMR), to identify rates and characteristics of self-reported “allergy” in a large tertiary care referral center population.

Methods: Demographic and allergy data were extracted from our EMR for outpatients and inpatients with point-of-care assessment of “allergy” at Cleveland Clinic (CC) sites in the USA, from August 1988 to August 2015.

Results: A total of 7,814,799 (51% males, 47% females) patients were evaluated at CC; 1,491,102 self-reported “allergies” were recorded. The top 10 were penicillin, sulfa, codeine, amoxicillin, morphine, seasonal allergies, aspirin, latex, contrast, and iodine, which comprised 87.5% of all reported items. Beta-lactams accounted for 47% of the total, sulfa 24%, codeine 13%, morphine 6%, aspirin 6%, latex 5.4% and ACE-inhibitors 2.8%. Drug allergy to these items was more frequent in males (72%) compared to females (28%) and patients over age 35: 35-65 years (45%) and 65 and older (39%). Penicillin allergy was reported in 4.6% of the total population, with the highest prevalence in ages 35-65. Patients age 0-17 were more likely to report amoxicillin than penicillin allergy (47% vs. 32%). There was a statistically significant difference for penicillin allergy in males compared to females (p<0.05, X2). Frequency of ACE-inhibitor reported allergy was higher in males and African-Americans.

Conclusions: The overwhelming majority of self reported “allergy” involves antibiotic or analgesic medications.  These data highlight the substantial morbidity related to medications, particularly beta-lactams, withheld due to self-reported “allergy” in a large tertiary care center population.