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Master Thesis

Le dépistage des allergies à la pénicilline en médecine générale : validation d'un arbre décisionnel simplifié auprès d'un centre d'allergologie de référence

Abstract : Penicillin allergy in general practice : validation of a decision algorithm. Aims : 10% of the population declare themselves allergic to penicillin, this diagnosis really only about 2% of patients. The general practitioner has a few ways to ensure the reality of this information and is torn between risk of recovery, loss of opportunity for the patient and incremental cost to society. To assist in evaluating the merits of this "alleged allergy" we wanted to create and validate a simple algorithm based on the interrogation. Methods : The study was conducted in the department of Allergology Tenon Hospital between the 01 march and the 30 november 2012. The algorithm developed based on data from the literature and expert opinion uncorked two distinct attitudes: either a possible reintroduction of penicillin in the medical office, or need for allergy tests. Each patient consultant for suspected penicillin allergy were included in the study. Following the consultation, the doctor filled the algorithm then conducts a full allergy testing. The results of allergy tests were then compared to the result of the algorithm to assess its validity. Results : 259 patients were included. 41 patients had a positive allergy tests. In the group reintroduction in general medicine, three patients were found allergic. The positive predictive value of the algorithm was 96.3%. The probability that a patient allergic be redirected in general practice was 3.7% (95% CI: 0.8-10.4). Conclusion : Despite a good PPV, the algorithm developed should not be used in general practice because the risk of anaphylactic shock is not zero.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01016546
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Submitted on : Friday, July 4, 2014 - 3:07:48 PM
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  • HAL Id : dumas-01016546, version 1

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Élodie Autegarden. Le dépistage des allergies à la pénicilline en médecine générale : validation d'un arbre décisionnel simplifié auprès d'un centre d'allergologie de référence. Allergologie. 2013. ⟨dumas-01016546⟩

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