The evaluation of drug provocation tests in pediatric allergy clinic: A single center experience
Drug provocation tests (DPTs) are gold standard to diagnose drug allergy. Our goal was to evaluate the results and safety of diagnostic methods including DPTs during childhood. Between January 2010 and February 2013 DPTs were performed and evaluated, prospectively, in children who attended
our pediatric allergy clinic with a suspected drug hypersensitivity reaction. One hundred ninety-eight suspected drug reactions in 175 patients (88 boys and 87 girls) were evaluated. The median age of the subjects at the time of the suspected drug-induced hypersensitivity reaction and at the
time of the study was 56 (interquartile range [IQR] = 24‐120 months) months and 76 (IQR = 35‐149 months) months, respectively. Suspected drugs were beta-lactam antibiotics in 108 cases (54.5%), non‐beta-lactam antibiotics in 22 cases (11.1%), and nonsteroid anti-inflammatory
drugs in 52 cases (26.3%). The history was compatible with immediate-type reactions in 69 cases (34.8%). Skin-prick tests were not positive in any of the cases. Intradermal tests were positive in three cases (4%). DPTs were positive in 13 (6.8%) of 191 provocation cases, which were performed
with culprit drugs. Our results suggest that a positive clinical history is not enough to make a diagnosis of drug allergy, which highlights the significance of undertaking further diagnostic evaluation especially for DPTs.
Keywords: Beta-lactam antibiotics; children; drug allergy; drug provocation test; immediate-type reactions; nonsteroid anti-inflammatory drugs; non‐beta-lactam antibiotics
Document Type: Research Article
Affiliations: Department of Pediatric Allergy and Immunology, Ankara Children’s Hematology Oncology Education and Research Hospital, Ankara, Turkey
Publication date: 01 March 2014
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