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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Intradermal Tests With Drugs: An Approach to Standardization

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  • Annick Barbaud
  • Marie Weinborn
  • Lene Heise Garvey
  • Sergio Testi
  • Violeta Kvedariene
  • Sevim Bavbek
  • Holger Mosbech
  • Eva Gomes
  • Werner Aberer
  • Hanneke N G Oude Elberink
  • Maria Jose Torres
  • Claude Ponvert
  • C Ayav
  • Jimmy Gooi
  • Knut Brockow
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Background: Intradermal tests (IDTs) are performed and interpreted differently in drug allergy centers making valid comparison of results difficult. Objective: To reduce method-related and intercenter variability of IDTs by the introduction of a standardized method. Materials and methods: In 11 centers of the European Network for Drug Allergy, IDTs were prospectively performed with saline and with amoxicillin (20 mg/ml) using (1) the local method and (2) the standardized European Network in Drug Allergy (ENDA) method (0.02 ml). The diameters of the initial injection wheal (Wi) for the different volumes and sites injected obtained from each center were analyzed. Results: The most reproducible method was to fill a syringe with test solution, then expel the excess fluid to obtain exactly 0.02 ml. The median Wi diameter with 0.02 ml injection using the standardized method was 5 mm [range 2-10 mm; interquartile range (IQR) 5-5 mm; n = 1,096] for saline and 5 mm (range 2-9 mm; IQR = 4.5-5 mm; n = 240) for amoxicillin. IDT injection sites did not affect the Wi diameter. Training improved precision and reduced the variability of Wi diameters. Conclusion: Using the standardized IDT method described in this multicenter study helped to reduce variability, enabling more reliable comparison of results between individuals and centers.

Original languageEnglish
JournalFrontiers in Medicine
Volume7
Pages (from-to)156
ISSN2296-858X
DOIs
Publication statusPublished - 15 May 2020

    Research areas

  • drug allergy, intradermal test, amoxicillin, standardization, specificity of drug skin tests

ID: 61764258