Penicillin Allergy Testing and Resensitization Rate

Centre Hospitalier Régional Metz-Thionville83 enrolled

Overview

Penicillin is one of the earliest discovered antibiotics and a drug of choice for several infections. Up to 10 to 20% of all patients in clinical trial are labeled as penicillin allergic. Most of these patients do not have a true allergy but few have had it verified. Approximately 80% of patients with IgE-mediated penicillin allergy lose their sensitivity after 10 years. Several studies have been conducted denying the risk of sensitization following negative testing of penicillin allergy. Investigators have not had the same experience and have therefore decided to conduct a retrospective study review of 83 adult outpatients with a distant penicillin allergy label and evaluate outcomes of skin retesting six weeks following Drug Provocation Test and challenge.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Penicillin Allergy

Interventions

Behavioral allergy testing protocolOTHER

skin tests followed by drug provocation test and skin retesting between 6 weeks and 6 months

Medical Language ↔ Plain English

Inclusion Criteria: \- 18 years old Exclusion Criteria: * Pregnancy * poorly controlled asthma and cardiovascular disease * use of drugs that interfere with testing and could not be stopped such as antihistamines, tricyclic antidepressants, antipsychotics, beta blockers, high dose oral glucocorticoids * Non-IgE mediated type of serious allergic reaction such as Stevens - Johnson syndrome, Toxic Epidermal Necrolysis, and Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome.

Outcomes

Primary Outcomes

efficacy of repeated skin testing

verified efficacy of repeated skin testing 4 weeks or more after drug provocation test and challenge in distant penicillin allergic patients. The reagents used for skin testing were as follow: Penicillin G, Clamoxyl, Augmentin,Tienam, Histamine and Normal saline (negative control). A skin test producing a papule with a diameter greater then 3 mm is considered as positive.

Time frame: week 4

Secondary Outcomes

efficacy of allergy testing

efficacy of allergy testing in identifying penicillin hypersensitivity reactions. Patients were called to perform, once again skin testing because skin tests sooner could result in false negatives due to the temporary desensitized state.

Time frame: Week 4