Full-Course Drug Challenge Test in the Diagnosis of Delayed Allergic Reactions to Penicillin
Full-Course Drug Challenge Test in the Diagnosis of Delayed Allergic Reactions to Penicillin
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DOI：
10.1159/000320384
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发表时间：
2011-01-01
影响因子：
2.8
通讯作者：
Bindslev-Jensen, Carsten
中科院分区：
文献类型：
--
作者：
Borch, Jakob E.;Bindslev-Jensen, Carsten
背景：药物激发试验（DCT）长期以来一直是调查青霉素过敏时过敏学检查中最敏感的测试。目的：提高青霉素治疗过程中第 2 天或之后有过敏反应史的青霉素过敏诊断检查的敏感性。方法：如果对青霉素治疗非立即反应的患者特异性 IgE、皮试和 DCT 均为阴性，则在当前方案中增加全程 DCT。 16 名曾对青霉素治疗有立即反应史的患者接受了检测，结果呈阴性。结果：50% 接受全程 DCT 的患者出现皮肤药物不良反应。对照组均未做出反应（p = 0.001）。平均反应时间为6天。青霉素 V 占大多数反应。荨麻疹是观察到的最常见的临床反应。结论：全程 DCT 提高了青霉素治疗第 2 天或之后发生的青霉素过敏反应诊断检查的敏感性和预测价值。版权所有 (C) 2011 S. Karger AG，巴塞尔
Background: Drug challenge test (DCT) has long been the most sensitive test in the allergological work-up when investigating for penicillin allergy. Objective: To improve sensitivity of the diagnostic work-up in diagnosing penicillin allergics with histories of allergic reactions on day 2 or later in the course of penicillin treatment. Methods: A full-course DCT was added to the current protocol if specific IgE, skin tests and DCT were all negative in patients who had a nonimmediate reaction to penicillin treatment. Sixteen patients with a history of an immediate reaction to penicillin treatment underwent testing with negative outcomes. Results: Fifty percent of patients undergoing full-course DCT experienced a cutaneous adverse drug reaction. None of the controls reacted (p = 0.001). The mean time of reaction was 6 days. Penicillin V accounted for most reactions. Urticaria was the most frequent clinical reaction observed. Conclusions: Full-course DCT offers an improvement of sensitivity and predictive values of the diagnostic work-up of allergic reactions to penicillin occurring on day 2 of penicillin treatment or later. Copyright (C) 2011 S. Karger AG, Basel