Content » Vol 92, Issue 3

Investigative Report

One-week Oral Challenge with Penicillin in Diagnosis of Penicillin Allergy

Janni Hjortlund, Charlotte Gotthard Mortz, Per Stahl Skov, Esben Eller, Johan Milling Holk Poulsen, Jakob Eli Borch, Carsten Bindslev-Jensen
DOI: 10.2340/00015555-1254

Abstract

Many patients experience reactions during penicillin treatment. The diagnosis may be difficult and is mainly based on short-term tests. The European Network for Drug Allergy (ENDA) guidelines proposed for diagnosing penicillin allergy do not include long-term challenge. In this study a total of 405 patients were evaluated. The ENDA guidelines were extended, to include a 7-day oral treatment (p.o.7) with penicillin for all patients who were negative in the ENDA programme. Among the 405 patients; 85 had an immediate reaction to penicillin, and a further 13 reacted during p.o.7. Among the 307 patients with a negative outcome, 88 had a case history of reaction to other β-lactam antibiotics and were subsequently tested with the culprit drug. Thirteen patients had a positive outcome: 3 on single-dose challenge and 10 during p.o.7. The extended penicillin diagnostic work-up was positive in 111 patients, 30.0% showed immediate reactions and 5.7% reacted during p.o.7. Approximately 20% of all patients with positive outcome during penicillin challenge are detected by adding p.o.7 with penicillin to the original ENDA guidelines.

Significance

Supplementary content

Comments

Not logged in! You need to login/create an account to comment on articles. Click here to login/create an account.