-
Original Article
-
Korean J Intern Med. 2026;41(6):1141-1151. Published online November 1, 2026.
DOI: https://doi.org/10.3904/kjim.2026.016
- Clinical features of moderate-to-severe antibiotic allergy in Korea: analysis from the drug allergy safety information sharing system database
-
Eunsik Bang1, Min-Ho Kang1, Jee Hyun Kim1, Won Jong Song1, Su Jeong Song1, Eunyoung Sa1, Jeong-Min Park1, Ji-Hyang Lee1,2, Jeong-Eun Yun3, Jiung Jeong4, Sujeong Kim4, Hwa Young Lee5, Kyung Hee Park6, Min-Gyu Kang7, Sang Min Lee8, So Ri Kim9, Sae-Hoon Kim10,11, Hye-Ryun Kang1,2,11
-
1Drug Safety Center, Seoul National University Hospital, Seoul, Korea
2Department of Internal Medicine, Division of Allergy and Clinical Immunology, Seoul National University College of Medicine, Seoul, Korea
3Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
4Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
5Division of Allergy, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
6Department of Internal Medicine, Institute of Allergy, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
7Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University, Cheongju, Korea
88Division of Respiratory Diseases and Allergy, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
9Division of Respiratory Medicine and Allergy, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Korea
10Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
11Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
- Corresponding author: Hye-Ryun Kang ,Tel: +82-2-2072-2865, Fax: +82-2-764-2199, Email: helenmed@snu.ac.kr
- Received: January 12, 2026; Revised: June 2, 2026 Accepted: June 16, 2026.
- Abstract
- Background/Aims
Antibiotics are major causes of drug allergy. Sharing standardized information on culprit agents is essential to prevent recurrent drug allergy. In 2024, the Ministry of Health and Welfare established the Drug Allergy Safety Information Sharing System (DASI), integrated with the Personal Health Record (PHR). We analyzed the epidemiology, culprit antibiotics, clinical manifestations, and diagnostic practices of antibiotic allergy in Korea using DASI data.
Methods
We retrospectively reviewed 807 cases of moderate-to-severe antibiotic allergy from eight tertiary hospitals. Clinical features were assessed according to reaction type, severity, MedDRA system organ class, culprit antibiotics, and diagnostic methods.
Results
Of 807 cases, the most common manifestations were cutaneous (77.1%), immune (35.2%), and respiratory (23.7%) symptoms. Most cases were caused by β-lactams, particularly second-generation cephalosporins (43.1%). Regarding single agent, cefaclor was the leading culprit (36.7%) and showed significant associations with immediate (odds ratio [OR] 13.88, 95% confidence interval [CI] 7.37–29.75) and severe reactions (OR 3.39, 95% CI 2.52–4.59). Immediate reactions frequently involved multiple organs, while 95.7% of delayed reactions involved the skin. β-lactams were the leading culprits of both immediate and delayed reactions, while sulfamethoxazole/trimethoprim, tetracyclines, and glycopeptides were identified as the major culprits of delayed reactions. Diagnosis relied mainly on clinical assessment (45.4%), while confirmatory drug provocation testing was performed in only 11.8%.
Conclusions
Immediate antibiotic allergy in Korea was mainly caused by β-lactams, with cefaclor identified as the leading culprit for severe reactions. Delayed reactions were characterized by a relatively greater contribution of non-β-lactam antibiotics than immediate reactions.
Keywords :Drug hypersensitivity; Anti-infective agents; β-lactams; Cephalosporins
