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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/40755
Title: Skin testing with β-lactam antibiotics for diagnosis of β-lactam hypersensitivity in children
Authors: Wiparat Manuyakorn
Prapasiri Singvijarn
Suwat Benjaponpitak
Wasu Kamchaisatian
Ticha Rerkpattanapipat
Cherapat Sasisakulporn
Wanlapa Jotikasthira
Mahidol University
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Sep-2016
Citation: Asian Pacific Journal of Allergy and Immunology. Vol.34, No.3 (2016), 242-247
Abstract: © 2016, Allergy and Immunology Society of Thailand. All rights reserved. Objective: Skin testing with penicilloyl-polylysine (PPL) and a minor determinant mixture (MDM) were previously recommended for evaluating β-lactam hypersensitivity. However, PPL and MDM have not been commercially available. This study was to determine the negative predictive value (NPV) of skin testing with β-lactam antibiotics for the diagnosis of β-lactam hypersensitivity. Method: Patients age 1-18 years old with a history of β-lactam hypersensitivity were evaluated by skin tests (a skin prick test, an intradermal test) with penicillin G, ampicillin, amoxicillin-clavulanic acid, and the suspect β-lactam. The patients who had a negative skin test were performed with a drug provocation test (DPT) in a 3-dose-graded challenge. The hypersensitivity reactions were classified into immediate and non-immediate reactions. Results: A total of 126 patients were evaluated for β-lactam hypersensitivity. Twenty two patients (17.4%) were confirmed with a β-lactam hypersensitivity. 12 (54.54 %) of them were confirmed by a skin test. There was no systemic reaction occurring after the skin tests. Ten patients (9.6%) from 104 patients with a negative skin test showed reactions after a DPT providing the NPV of the skin test with a 91.2% value. 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.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84992065239&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/40755
ISSN: 22288694
0125877X
Appears in Collections:Scopus 2016-2017

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