Clin Transl Allergy

Common drugs implicated in anaphylaxis risk following mild reactions

May 19, 2025

Study details: This multicenter retrospective study analyzed data from a Korean drug-induced anaphylaxis registry across 10 university hospitals. Researchers examined 494 cases of drug-induced anaphylaxis, focusing on 77 patients (15.6%) who had a prior non-severe drug hypersensitivity reaction (DHR) to identify clinical characteristics and risk factors for escalation to anaphylaxis.

Results: Among those with prior DHR, 56% had reacted to a drug of the same class. Anaphylaxis was more likely to occur in daily life (vs. hospital settings) in this group (48.8% vs. 23.5% or 22.5%, p = 0.008 and <0.001). NSAIDs, H2 blockers, and penicillins were the most frequently implicated drug classes. Patients with prior mild reactions to these drugs were at higher risk for escalation upon re-exposure.

Clinical impact: The findings underscore the importance of recognizing non-severe DHRs as potential precursors to anaphylaxis. Exercise heightened caution when re-prescribing NSAIDs, H2 blockers, or penicillins to patients with a history of mild reactions, and consider alternative therapies or allergy evaluation to mitigate risk.

Source:

Rhyou HI, et al. (2025, April). Clin Transl Allergy. Clinical characteristics and risk factors for escalation to anaphylaxis from non-severe drug hypersensitivity reaction. https://pubmed.ncbi.nlm.nih.gov/40263639/