Intradermal Tests With Drugs: An Approach to Standardization
Intradermal Tests With Drugs: An Approach to Standardization
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DOI：
10.3389/fmed.2020.00156
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发表时间：
2020-05-15
影响因子：
3.9
通讯作者：
Brockow, Knut
中科院分区：
文献类型：
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作者：
Barbaud, Annick;Weinborn, Marie;Brockow, Knut
目的：通过引入标准化方法来减少皮内试验的方法相关性和中心间的变异性。材料和方法：在欧洲药物过敏网络的11个中心中，采用(1)当地方法和(2)欧洲药物过敏标准化网络(ENDA)方法(0.02ml)前瞻性地进行皮内试验。结果：重复性最好的方法是在注射器中注入试液，然后排出多余的液体，准确地获得0.02ml，用标准化方法注射0.02ml，平均直径：生理盐水5 mm[范围2~10 mm；四分位数范围5~5 mm；n=1096]；阿莫西林5 mm(范围2~9 mm；IQR=4.5~5 mm；n=240)。IDT注射部位对Wi直径无明显影响。结论：使用本多中心研究中描述的标准化IDT方法有助于降低变异性，使个人和中心之间的结果比较更加可靠。
Background: Intradermal tests (IDTs) are performed and interpreted differently in drug allergy centers making valid comparison of results difficult.Objective: To reduce method-related and intercenter variability of IDTs by the introduction of a standardized method.Materials and methods: In 11 centers of the European Network for Drug Allergy, IDTs were prospectively performed with saline and with amoxicillin (20 mg/ml) using (1) the local method and (2) the standardized European Network in Drug Allergy (ENDA) method (0.02 ml). The diameters of the initial injection wheal (Wi) for the different volumes and sites injected obtained from each center were analyzed.Results: The most reproducible method was to fill a syringe with test solution, then expel the excess fluid to obtain exactly 0.02 ml. The median Wi diameter with 0.02 ml injection using the standardized method was 5 mm [range 2-10 mm; interquartile range (IQR) 5-5 mm; n = 1,096] for saline and 5 mm (range 2-9 mm; IQR = 4.5-5 mm; n = 240) for amoxicillin. IDT injection sites did not affect the Wi diameter. Training improved precision and reduced the variability of Wi diameters.Conclusion: Using the standardized IDT method described in this multicenter study helped to reduce variability, enabling more reliable comparison of results between individuals and centers.