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- Mild to moderate hypersensitivity reactions to beta-lactams in children: a single-centre retrospective review. [Journal Article]
- BPBMJ Paediatr Open 2019; 3(1):e000435
- CONCLUSIONS: In mild and moderate cases of BL hypersensitivity, diagnosis can be performed by DPT without previous ST.
- Evaluating Penicillin Allergies Without Skin Testing. [Review]
- CACurr Allergy Asthma Rep 2019 Mar 22; 19(5):27
- An unconfirmed penicillin allergy is known to confer significant risk to patients. Only a small minority of patients labeled with penicillin allergy will be confirmed to be hypersensitive with the cu…
An unconfirmed penicillin allergy is known to confer significant risk to patients. Only a small minority of patients labeled with penicillin allergy will be confirmed to be hypersensitive with the current reference standard test, an oral amoxicillin therapeutic dose challenge. Skin testing has been recommended prior to oral challenges to reduce the risk of severe acute challenge reactions. The rate of severe acute anaphylactic reactions with oral amoxicillin is currently extremely low. Unfortunately, penicillin skin testing, as commonly performed, has a high rate of false positive results.
- Penicillin Allergy Evaluation: A Prospective, Multicenter, Open-Label Evaluation of a Comprehensive Penicillin Skin Test Kit. [Journal Article]
- JAJ Allergy Clin Immunol Pract 2019 Mar 13
- CONCLUSIONS: The Penicillin Skin Test Kit, containing all relevant penicillin allergenic determinants, demonstrated very high NPV. Removal of a penicillin allergy label in a large majority of currently mislabeled patients has substantial personal and public health implications.
- Penicillin minor determinants: History and relevance for current diagnosis. [Review]
- AAAnn Allergy Asthma Immunol 2018; 121(5):537-544
- CONCLUSIONS: IgE skin testing, using both the major and appropriate minor determinants of penicillin, can identify, with a high degree of reliability (NPV ∼97%), penicillin allergy history-positive patients who can receive beta-lactam antibiotics without concern for serious acute allergy, including anaphylaxis. The few false-negative skin tests reported globally are largely confined to minor, self-limited cutaneous reactions.
- Evaluation of Penicillin Allergy in the Hospitalized Patient: Opportunities for Antimicrobial Stewardship. [Review]
- CACurr Allergy Asthma Rep 2017; 17(6):40
- Penicillin allergy is often misdiagnosed and is associated with adverse consequences, but testing is infrequently done in the hospital setting. This article reviews historical and contemporary innova…
Penicillin allergy is often misdiagnosed and is associated with adverse consequences, but testing is infrequently done in the hospital setting. This article reviews historical and contemporary innovations in inpatient penicillin allergy testing and its impact on antimicrobial stewardship.
- A Proactive Approach to Penicillin Allergy Testing in Hospitalized Patients. [Journal Article]
- JAJ Allergy Clin Immunol Pract 2017 May - Jun; 5(3):686-693
- CONCLUSIONS: Penicillin allergy testing using a physician-pharmacist team model effectively removes reported allergies in hospitalized patients. The electronic medical record is a valuable asset for locating and stratifying individuals who benefit most from intervention. Proactive testing substantially reduces unnecessary inpatient and outpatient use of beta-lactam alternatives that may otherwise go unaddressed.
- Skin testing with β-lactam antibiotics for diagnosis of β-lactam hypersensitivity in children. [Clinical Trial]
- APAsian Pac J Allergy Immunol 2016; 34(3):242-247
- CONCLUSIONS: Among those children with a history of β-lactam hypersensitivity, skin testing with penicillin G, ampicillin, amoxicillin-clavulanic acid, and the suspect β-lactam was safe and provided a good NPV when PPL and MDM were unavailable. However, a skin test with β-lactam antibiotics alone did not provide a high sensitivity, thus a DPT procedure was necessary in order to confirm the diagnosis of β-lactam hypersensitivity.
- The Importance of Amoxicillin and Amoxicillin-Clavulanate Determinants in the Diagnosis of Immediate Allergic Reactions to β-Lactams. [Journal Article]
- IAInt Arch Allergy Immunol 2016; 170(1):62-6
- CONCLUSIONS: Skin testing with AMX and AMX-C is mandatory in patients with immediate allergy to these drugs. Failure to perform it may result in a false-negative ST jeopardizing these patients with anaphylactic reactions during a hazardous OCT.
- Skin testing only with penicillin G in children with a history of penicillin allergy. [Journal Article]
- AAAnn Allergy Asthma Immunol 2014; 113(1):75-81
- CONCLUSIONS: Among children with a history of penicillin allergy, skin testing only with penicillin G followed by a 3-dose graded challenge to the incriminated penicillin is safe and yields a good NPV. This approach could be useful when PPL is unavailable.
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- The time for penicillin skin testing is here. [Editorial]
- JAJ Allergy Clin Immunol Pract 2013 May-Jun; 1(3):264-5