[Drug Allergies in Elderly Patients: The Outcomes of Allergic Evaluation and Long-Term Follow-up]

Adults over 65 years constitute the fastest-growing segment of the Western population. Drug allergies represent a significant health concern in this age group. This study aimed to assess the safety and efficacy of drug allergy evaluation in geriatric patients.

We conducted a retrospective study of patients aged >65 years who were referred for allergy evaluation at the Allergy and Clinical Immunology Unit, Meir Medical Center. The evaluation included a detailed anamnesis, skin testing when indicated, and oral drug challenges. Patients who were successfully de-labelled were followed long-term to assess subsequent use of the culprit drug and related outcomes.

Between 2009 and 2019, a total of 1,860 elderly patients were evaluated in our clinic, of whom 270 were referred with suspected drug allergies. Ultimately, 232 patients (86.2%) had their drug allergy ruled out. Patients confirmed as allergic were offered therapeutic options, including drug desensitization when required or alternative medications when available. The evaluation process proved safe, with no severe reactions occurring during oral challenges or drug desensitizations. Long-term follow-up data were available for 144 patients, of whom 50 (34.7%) were subsequently treated with the previously suspected culprit drug. None experienced immediate reactions or severe delayed hypersensitivity following re-exposure.

Drug allergy de-labelling is both safe and effective in elderly patients, underscoring the importance of implementing this procedure. Greater awareness is needed regarding the value of allergy workups in geriatric populations carrying drug allergy labels.