The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.
Skin testing and oral penicillin challenge in patients with a history of remote penicillin allergy.
Abstract
Background Penicillin administration is usually contraindicated in penicillin-allergic patients with positive skin test results.Objective To examine whether penicillin oral challenge for patients with a history of remote non-life-threatening allergic reaction to penicillin can be well tolerated irrespective of skin test results.Methods In a prospective open-label trial, 8,702 individuals were screened between November 1998 and January 2000. Of 687 patients with a non-life-threatening allergic reaction to penicillin, occurring longer than 3 years earlier, 169 were enrolled. Regardless of the response to penicillin skin testing, patients received the usual 1-day dosage of penicillin and amoxicillin, on 2 separate occasions. Two to 6 years later, a follow-up was conducted to assess the outcomes of further penicillin administration.Results A total of 272 combined skin tests and oral challenges were performed on 169 patients. Among 137 challenges with a positive skin test result and 135 patients with a negative skin test result, 9 (6.6%) and 5 (3.7%) (P = .29), respectively, developed a mild rash to oral challenge. At follow-up, 2 to 6 years afterward, 3 of 55 patients (5.5%) who were given a full treatment course of penicillin developed a mild skin eruption.Conclusions Positive penicillin skin test results for patients with a remote history of non-life-threatening allergic reaction to penicillin were not associated with a greater prevalence of adverse reactions to oral challenge with penicillin than negative results. Because skin testing is considered the gold standard and the safest method for predicting tolerance to penicillin administration, oral penicillin challenge may be used as a diagnostic method only in these specific patients when skin testing is not feasible.
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“Moreover, in studies that have incorporated penicillin skin testing and graded oral challenge among persons with reported penicillin allergy, the true rates of allergy are low, ranging from 1.5% to 6.1% (665–667).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [666]
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Immediate hypersensitivity reactions to penicillin and related antibiotics
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Skin testing to detect penicillin allergy
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Natural evolution of skin test sensitivity in patients allergic to β-lactam antibiotics
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Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 3,018
Drug Allergy: An Updated Practice Parameter
(2010) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2010.08.002 · Cited by 982
International Con sensus on drug allergy
Demoly, P. M., Adkinson, N. F., Brockow, K., Castells, M., Chiriac, A. M., Greenberger, P. A., Khan, D. A., Lang, D. M., Park, H., Pichler, W. J., et al. (2014) · Allergy · doi:10.1111/all.12350 · Cited by 932
Update on the evaluation of hypersensitivity reactions to betalactams
Blanca, M., Romano, A. G., Torres, M. J., Fernández, J., Mayorga, C., Rodriguez, J., Demoly, P. M., Bousquet, P., Merk, H. F., Sanz, M. L., et al. (2009) · Allergy · doi:10.1111/j.1398-9995.2008.01924.x · Cited by 450
Caubet, J., Kaiser, L., Lemaître, B., Fellay, B., Gervaix, A., & Eigenmann, P. (2010) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2010.08.025 · Cited by 343
Metadata
- Authors
- Goldberg, A., & Confino-Cohen, R.
- Affiliations
- Tel Aviv University (IL)
- Corresponding author
- Goldberg, Arnon
- Venue
- Annals of Allergy, Asthma & Immunology
- Publisher
- Elsevier BV
- Published
- 2008-01
- Volume
- 100
- Issue
- 1
- Pages
- 37-43
- ISSN
- 1081-1206 (ISSN-L)
- OpenAlex
- W2015194386
- Cited by
- 83
- References
- 35
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 1 · 2019: 9 · 2018: 10 · 2017: 6 · 2016: 4 · 2015: 3 · 2014: 6 · 2013: 4 · 2012: 1
- FWCI
- 3.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Allergy Asthma & Immunology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Drug-Induced Adverse Reactions
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Keywords
- penicillin allergy, penicillin skin testing, drug tolerance, amoxicillin, drug hypersensitivity diagnosis, adverse drug reactions
- MeSH terms
- Administration, Oral, Adolescent, Adult, Aged, Aged, 80 and over, Amoxicillin, Ampicillin, Child, Child, Preschool, Drug Hypersensitivity, Female, Follow-Up Studies, Humans, Male, Middle Aged, Penicillin G, Penicillin V, Penicillins, Predictive Value of Tests, Prospective Studies, Skin Tests, Benzeneacetamides
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