{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T18:01:26Z","timestamp":1781373686801,"version":"3.54.1"},"reference-count":41,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102023\u201000248157"],"award-info":[{"award-number":["RS\u20102023\u201000248157"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["RS\u20102024\u201000438239"],"award-info":[{"award-number":["RS\u20102024\u201000438239"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite antibiotic\u2010induced anaphylaxis being a severe allergic reaction requiring immediate care, large\u2010scale studies examining all antibiotic subtypes remain limited. This study addresses this gap by analysing 33 antibiotic classes, along with epidemiological and regional variations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study utilised the world's largest pharmacovigilance database, with over 35 million individual case safety reports from 140 countries. The study employed a two\u2010step approach: first, the antibiotics were grouped into 10 categories according to their third\u2010level ATC codes and their frequencies were collectively analysed. These categories comprised tetracyclines (J01A), amphenicols (J01B), beta\u2010lactam antibacterial penicillins (J01C), other beta\u2010lactam antibacterials (J01D), sulfonamides and trimethoprim (J01E), macrolides, lincosamides and streptogramins (J01F), aminoglycoside antibacterials (J01G), quinolone antibacterials (J01M), combinations of antibacterials (J01R) and other antibacterials (J01X). Second, a more detailed analysis was performed at the fourth level of the ATC codes for the antibiotics categorised at the third level, focusing on 33 individual antibiotics. For statistical analysis, disproportionality metrics, including the information component (IC) with IC\n                      <jats:sub>025<\/jats:sub>\n                      and reporting odds ratio (ROR) with 95% CI, were used to classify and analyse the risk of anaphylaxis related to these drugs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 144,820 reports were identified as antibiotic\u2010induced anaphylaxis. All antibiotics showed significant signal detection for anaphylaxis (ROR, 20.50 [95% CI, 20.37\u201320.63]; IC, 3.77 [IC\n                      <jats:sub>025<\/jats:sub>\n                      , 3.76]) across all age groups and sexes. The following three antibiotics took the most proportion of the reports: penicillins (39,696\/144,820 [27.4%]; ROR, 18.82 [95% CI, 18.62\u201319.01]; IC, 4.04 [IC\n                      <jats:sub>025<\/jats:sub>\n                      , 4.02]), other beta\u2010lactam antibiotics (63,644\/144,820 [43.9%]; 27.59 [27.35\u201327.83]; 4.48 [4.46]) and quinolones (20,303\/144,820 [14.0%]; 13.40 [13.21\u201313.60]; 3.63 [3.61]). The median time\u2010to\u2010onset was 1\u2009day (interquantile range, 1\u20131), with most r recovered (96.09%) and the fatality rate accounting for 1.23%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although our findings do not permit causal inference, the analysis highlights the need for standardised grading systems, patient\u2010specific risk factors and long\u2010term outcome studies to improve prevention and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cea.70121","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T04:44:56Z","timestamp":1753850696000},"page":"1219-1227","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Global Burden of Drug\u2010Induced Anaphylaxis Associated With 33 Classes of Antibiotics (1968\u20132024): A Pharmacovigilance Analysis"],"prefix":"10.1111","volume":"55","author":[{"given":"Jaehyeong","family":"Cho","sequence":"first","affiliation":[{"name":"Center for Digital Health Medical Science Research Institute, Kyung Hee University College of Medicine  Seoul South Korea"},{"name":"Department of Medicine CHA University School of Medicine  Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeongseon","family":"Oh","sequence":"additional","affiliation":[{"name":"Center for Digital Health Medical Science Research Institute, Kyung Hee University College of Medicine  Seoul South Korea"},{"name":"Department of Precision Medicine Kyung Hee University College of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2009-386X","authenticated-orcid":false,"given":"Jaeyu","family":"Park","sequence":"additional","affiliation":[{"name":"Center for Digital Health Medical 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