BACKGROUND: Skin testing has a limited role in the diagnosis of non-immediate beta-lactam hypersensitivity in children. The aim of this study was to report the results of oral provocation tests performed without skin tests in children with non-immediate mild cutaneous reactions without systemic symptoms caused by beta-lactam antibiotics. METHODS: Oral provocation tests with suspected antibiotics were performed to patients with non-immediate mild cutaneous reactions without systemic symptoms caused by beta-lactam antibiotics. Skin tests were not performed before provocation tests. A total of five doses were administered with half-an-hour intervals in increasing doses. Provocation was continued for 5 days. RESULTS: A total of 119 patients with a median age of 4.3 (IQR: 2-7.5) years, of whom 58% were males, were included in the study. Amoxicillin-clavulanic acid was the most frequently responsible agent in 87 (73.1%) patients, and most common type of rash was maculopapular in 74 (62.2%) patients. Four patients (3.4%) had an urticarial reaction during the provocation test. CONCLUSION: We did not experience any severe reactions during oral provocation test without previous skin tests performed to children with non-immediate mild cutaneous reactions without systemic symptoms. Omitting skin tests before oral provocation test in this group of children can help decreasing the burden of allergy clinics and alleviating the discomfort of children.
BACKGROUND: Skin testing has a limited role in the diagnosis of non-immediate beta-lactamhypersensitivity inchildren. The aim of this study was to report the results of oral provocation tests performed without skin tests in children with non-immediate mild cutaneous reactions without systemic symptoms caused by beta-lactam antibiotics. METHODS: Oral provocation tests with suspected antibiotics were performed to patients with non-immediate mild cutaneous reactions without systemic symptoms caused by beta-lactam antibiotics. Skin tests were not performed before provocation tests. A total of five doses were administered with half-an-hour intervals in increasing doses. Provocation was continued for 5 days. RESULTS: A total of 119 patients with a median age of 4.3 (IQR: 2-7.5) years, of whom 58% were males, were included in the study. Amoxicillin-clavulanic acid was the most frequently responsible agent in 87 (73.1%) patients, and most common type of rash was maculopapular in 74 (62.2%) patients. Four patients (3.4%) had an urticarial reaction during the provocation test. CONCLUSION: We did not experience any severe reactions during oral provocation test without previous skin tests performed to children with non-immediate mild cutaneous reactions without systemic symptoms. Omitting skin tests before oral provocation test in this group of children can help decreasing the burden of allergy clinics and alleviating the discomfort of children.
Authors: Cosby A Stone; Jason Trubiano; David T Coleman; Christine R F Rukasin; Elizabeth J Phillips Journal: Allergy Date: 2019-05-26 Impact factor: 13.146
Authors: Jason A Trubiano; Karin A Thursky; Andrew J Stewardson; Karen Urbancic; Leon J Worth; Cheryl Jackson; Wendy Stevenson; Michael Sutherland; Monica A Slavin; M Lindsay Grayson; Elizabeth J Phillips Journal: Clin Infect Dis Date: 2017-07-01 Impact factor: 9.079
Authors: Jason A Trubiano; M Lindsay Grayson; Karin A Thursky; Elizabeth J Phillips; Monica A Slavin Journal: Med J Aust Date: 2018-06-18 Impact factor: 7.738
Authors: Kyra Y L Chua; Sara Vogrin; Susan Bury; Abby Douglas; Natasha E Holmes; Nixon Tan; Natasha K Brusco; Rebecca Hall; Belinda Lambros; Jacinta Lean; Wendy Stevenson; Misha Devchand; Kent Garrett; Karin Thursky; M Lindsay Grayson; Monica A Slavin; Elizabeth J Phillips; Jason A Trubiano Journal: Clin Infect Dis Date: 2021-08-02 Impact factor: 9.079