Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Safe De-Labeling of Patients at Low Risk of Penicillin Allergy in Denmark

Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

DOI

  1. Intradermal Testing Identifies 1 in 4 Patients with Nonimmediate Penicillin Allergy

    Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

  2. The Clinical Relevance of Natural Rubber Latex-Specific IgE in Patients Sensitized to Timothy Grass Pollen

    Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

  3. How Not to Be Misled by Disorders Mimicking Angioedema: A Review of Pseudoangioedema

    Publikation: Bidrag til tidsskriftReviewpeer review

  4. Insect Sting Reactions and Specific IgE to Venom and Major Allergens in a General Population

    Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

  1. Characterization of Mast Cells from Healthy and Varicose Human Saphenous Vein

    Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

  2. Development and validation of the Food Allergy Severity Score

    Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

  3. Reliability of early and late testing for suspected perioperative hypersensitivity

    Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review

Vis graf over relationer

INTRODUCTION: Penicillin allergy is suspected in 10% of hospital inpatients but can be disproved in 90% of cases. Direct oral provocation without preceding tests among low-risk patients has proven to be safe in studies of both children and adults and is gaining use across the world. The aims of this study were to investigate the rate of severe allergic reactions to direct oral drug provocation, without preceding tests, in penicillin allergy patients stratified to be at low risk, as well as to examine if these patients have barriers to penicillin allergy de-labeling and future use of penicillins.

METHODS: Adult patients referred to a university hospital allergy clinic with a suspected penicillin allergy were prospectively risk evaluated. Patients stratified to be at low risk were offered a direct oral provocation with a single-dose amoxicillin followed by 4 days of continued treatment. The same risk stratification criteria were applied to a larger retrospective cohort.

RESULTS: In the prospective study population, 202 patients had a direct oral drug provocation and 20 (10%) were positive. There were no cases of anaphylaxis or severe delayed hypersensitivity. Fifteen reactions were benign rashes with onset >1 day after initial dosing, and 13 of these were maculopapular rashes. The same low-risk criteria were applied retrospectively to patients in a drug provocation database, and 1,759 patients fulfilled the criteria; of these, 10% had positive provocations, and there were no cases of anaphylaxis or severe delayed hypersensitivity. De-labeled patients in the prospective study reported not to fear future penicillin intake, after prolonged provocation.

CONCLUSION: The risk stratification criteria for identifying low-risk patients for the oral drug provocation test without prior skin testing were safe in terms of avoiding anaphylaxis or severe delayed hypersensitivity. Benign delayed skin reactions still occurred, and access to allergy advice and follow-up is necessary.

OriginalsprogEngelsk
TidsskriftInternational Archives of Allergy and Immunology
Vol/bind183
Udgave nummer6
Sider (fra-til)640-650
Antal sider11
ISSN1018-2438
DOI
StatusUdgivet - 1 jun. 2022

Bibliografisk note

© 2022 S. Karger AG, Basel.

ID: 73846798