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One-week Oral Challenge with Penicillin in Diagnosis of Penicillin Allergy

J Hjortlund, C Mortz, P Skov, E Eller, J Poulsen, J Borch, C Bindslev-Jensen
2012 Acta Dermato-Venereologica  
Many patients experience reactions during penicillin treatment. The diagnosis may be difficult and is mainly based on short-term tests. The European Network for Drug Allergy (ENDA) guidelines proposed for diagnosing penicillin allergy do not include long-term challenge. In this study a total of 405 patients were evaluated. The ENDA guidelines were extended, to include a 7-day oral treatment ( p.o.7) with penicillin for all patients who were negative in the ENDA programme. Among the 405
more » ... ng the 405 patients; 85 had an immediate reaction to penicillin, and a further 13 reacted during p.o.7. Among the 307 patients with a negative outcome, 88 had a case history of reaction to other β-lactam antibiotics and were subsequently tested with the culprit drug. Thirteen patients had a positive outcome: 3 on single-dose challenge and 10 during p.o.7. The extended penicillin diagnostic work-up was positive in 111 patients, 30.0% showed immediate reactions and 5.7% reacted during p.o.7. Approximately 20% of all patients with positive outcome during penicillin challenge are detected by adding p.o.7 with penicillin to the original ENDA guidelines.
doi:10.2340/00015555-1254 pmid:22170236 fatcat:frxal2c7cbhpbd4xbnauvo3egi