Mateusz Skotnicki

Background: Beta-lactam antibiotic allergy is one of the most frequently reported drug hypersensitivities. True allergy is rarely confirmed. Inaccurate labeling leads to unnecessary avoidance of beta-lactams, antimicrobial resistance, and increased healthcare costs. Delabeling is mainly evaluated using electronic databases, whereas patient perceptions, quality of life, and real-world barriers remain uncertain. Methods: This cross-sectional, questionnaire-based study included 96 adults with a reported history of beta-lactam hypersensitivity: 46 after successful specialist delabeling and 50 before specialist evaluation. Structured telephone interviews assessed diagnostic pathways, perceived correctness of diagnosis or exclusion, confidence in beta-lactam safety, antibiotic use, and symptom recurrence. Quality of life was assessed using the WHOQOL-BREF questionnaire. Results: Perceived safety of beta-lactam antibiotics was significantly higher in the delabeled group than in the non-delabeled group (7.37 vs. 2.40; p < 0.001). WHOQOL-BREF scores were similar between groups, except for a small difference in the Environment domain, favoring delabeled (p = 0.029) patients. Among delabeled patients, 57% required antibiotics during follow-up; of these, 65% received beta-lactams. In 35% of cases with an indication, physicians withheld beta-lactams despite documented delabeling. Self-reported mild cutaneous symptoms occurred in 18% of patients re-exposed to beta-lactam antibiotics despite delabeling; the significance of this finding needs to be assessed in the future. Conclusions: Patients who underwent beta-lactam allergy delabeling reported greater perceived safety regarding the use of beta-lactam antibiotics, while no significant differences in quality of life were observed. Persistent reluctance among patients and physicians may, however, limit the real-world benefits of delabeling.

Background: Several strategies such as premedication or allergologic work-up have been used to facilitate safe iodinated contrast media (ICM) application. The aim of this study was to assess the negative predictive value of skin tests and complete allergologic work-up with iodinated contrast media in real-life settings. Methods: We retrospectively enrolled 210 patients with a history of immediate hypersensitivity reactions to ICMs. The stepwise protocol of selecting safe ICMs included skin prick tests (SPTs), intracutaneous tests (ICTs), and intravenous drug provocation tests (DPTs). The tests were performed with one or more of the following medications: iohexol, iodixanol, iomeprol, iopromide, and ioversol. At least 6 months after selecting safe ICMs, a telephone follow-up was scheduled. Based on this data, negative predictive values of skin tests and the whole work-up were calculated. Results: Overall, we obtained the following rates of positive tests: SPT—12% (55/441); ICT—10% (40/383); and DPT—5% (10/195). The highest rates of positive work-ups were found in patients tested within 1 year after the reaction and patients with a history of urticaria/angioedema after ICMs. The skin tests and DPTs determined a safe ICM in 184/210 (87%) patients. The negative predictive value of skin tests in reference to DPTs in hospital settings was 95%. Finally, a telephone follow-up demonstrated that 75/184 participants (41%) had been given the recommended ICM, including 68 cases (37%) with no subsequent hypersensitivity reaction and 7 (4%) with a reaction. The negative predictive value of allergologic work-up consisting of SPTs, ICTs and DPTs in real-life settings was 90%. Conclusions: Skin tests and intravenous drug provocation tests with ICMs are characterised by high negative predictive value, and enable the determination of safe ICMs for most patients.

Background: Food neophobia, defined as the fear of eating new and unfamiliar foods, can influence the development of children’s eating habits and limit the variety in their diets. The present study aimed to assess the level of food neophobia in children based on parents’ opinions and to analyse their attitudes towards a variety of foods. Methods: The survey was conducted in the form of a questionnaire. The study was conducted in two stages. In the first stage, children’s level of neophobia was assessed using the Children’s Food Neophobia Scale (CFNS), which was completed by parents/guardians. A total of 133 participants representing paired responses were selected for analysis. In the second stage, children completed an original graphic questionnaire assessing their attitudes towards selected foods, divided into groups: positively, negatively, and neutrally perceived. The survey was conducted in a primary school in Pomeranian Province in January 2025. The Kruskal–Wallis test was used as a non-parametric statistical test to compare three groups. If necessary, post hoc tests (Dunn’s or Tukey’s) were performed to determine between which specific groups the differences existed. To assess the statistical relationship between the level of neophobia declared by parents and the type of attitudes among children, Pearson’s Chi2 test was used with a statistical significance level of p < 0.05. Results: It was found that 42.11% of children showed a high level of food neophobia, indicating a significant problem in the acceptance of new products in the diet. Commonly known and widely consumed products, such as ice cream, tomatoes, and cutlets, received the highest ratings. Edible insects and edible flowers were the least preferred. The Kruskal–Wallis test revealed significant differences in the level of neophobia among the three groups, and post hoc Tukey tests were conducted to determine the specific groups between which these differences occurred. Children with high and low levels of neophobia can exhibit both positive and negative attitudes toward different types of food. Conclusions: The results of the study highlight the importance of nutrition education for children and their parents to reduce fear of new products and promote more variety in the diet. Future research would benefit from examining the influence of family and peer environment on the development of food neophobia.