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Assessment of a new brand of determinants for skin testing in a large group of patients with suspected beta-lactam allergy

Matheu, Victor LU ; Perez, E; Gonzalez, R; Poza, P; de la Torre, F; Sanchez-Machin, I and Garcia-Robaina, J C (2007) In Journal of Investigational Allergology & Clinical Immunology 17(4). p.257-260
Abstract (Swedish)
Abstract in Spanish

Antecedentes: Las pruebas cutáneas con determinantes mayores y menores de la penicilina se utilizan de forma habitual para el diagnóstico de reacciones de hipersensibilidad inmediata a los antibióticos betalactámicos. Estos extractos diagnósticos han sido recientemente retirados del mercado europeo.

Objetivo: Estudio de una nueva marca de determinantes para el diagnóstico de reacciones alérgicas a penicilina.

Métodos: Se realizaron pruebas cutáneas en prick e intradérmicas con una nueva marca comercial de PPL (benzilpeniciloil polilisina) y MDM (benzilpenicilina sódica, benzil peniciloato sódico y ácido benzilpeniciloico), penicilina, amoxicilina y el betalactámico implicado. Si las... (More)
Abstract in Spanish

Antecedentes: Las pruebas cutáneas con determinantes mayores y menores de la penicilina se utilizan de forma habitual para el diagnóstico de reacciones de hipersensibilidad inmediata a los antibióticos betalactámicos. Estos extractos diagnósticos han sido recientemente retirados del mercado europeo.

Objetivo: Estudio de una nueva marca de determinantes para el diagnóstico de reacciones alérgicas a penicilina.

Métodos: Se realizaron pruebas cutáneas en prick e intradérmicas con una nueva marca comercial de PPL (benzilpeniciloil polilisina) y MDM (benzilpenicilina sódica, benzil peniciloato sódico y ácido benzilpeniciloico), penicilina, amoxicilina y el betalactámico implicado. Si las pruebas cutáneas resultaban negativas se realizaba test de provocación oral simple ciego con penicilina o el medicamento implicado. Si las pruebas cutáneas y la provocación resultaban negativas se repetían 2-4 semanas más tarde.

Resultados: Se estudiaron 636 pacientes con sospecha de alergia a betalactámicos. Sesenta y nueve presentaron un estudio positivo. Las pruebas cutáneas con PPL fueron positivas en 30 pacientes (46.8%) y 28 con MDM (43.7%). Dieciséis presentaron pruebas cutáneas positivas a PPL y MDM (25%) y 42 pacientes presentaron positividad a PPL o MDM (65.6%). Treinta y dos presentaron pruebas cutáneas

a penicilina G u otro betalactámico. Cinco pacientes presentaron pruebas cutáneas negativas con prueba de provocación oral positiva.

Conclusiones: Se confi rma la utilidad y fi abilidad de la nueva marca de determinantes comerciales disponible en Europa para el diagnóstico de reacciones de hipersensibilidad inmediata a betalactámicos. Se trata de una alternativa segura a la utilizada previamente. (Less)
Abstract
BACKGROUND: Skin testing with major and minor determinants of benzylpenicillin is recommended standard practice for the evaluation of patients with immediate hypersensitivity reactions to beta-lactams. However, commercial reagents for this purpose were recently dropped from the European market. OBJECTIVE: In the present study, we assessed a new brand of reagents for use in skin testing in patients with suspected penicillin allergy. METHODS: Prick tests and intradermal tests were performed with benzylpenicilloyl polylysine (PPL) and minor determinant mixture (MDM). Penicillin G, amoxicillin, and the culprit beta-lactam were also tested. If skin tests were negative, a single-blind oral challenge test was performed with the culprit active... (More)
BACKGROUND: Skin testing with major and minor determinants of benzylpenicillin is recommended standard practice for the evaluation of patients with immediate hypersensitivity reactions to beta-lactams. However, commercial reagents for this purpose were recently dropped from the European market. OBJECTIVE: In the present study, we assessed a new brand of reagents for use in skin testing in patients with suspected penicillin allergy. METHODS: Prick tests and intradermal tests were performed with benzylpenicilloyl polylysine (PPL) and minor determinant mixture (MDM). Penicillin G, amoxicillin, and the culprit beta-lactam were also tested. If skin tests were negative, a single-blind oral challenge test was performed with the culprit active principle or penicillin. If both skin tests and challenge tests were negative, the same procedure was repeated between 2 and 4 weeks later. RESULTS: A total of 636 patients were assessed. The allergy study was positive in 69 patients. Skin tests with PPL were positive in 30 patients (46.8%) and with MDM in 28 (43.7%). Sixteen patients displayed a positive reaction to both PPL and MDM (25%), while 42 patients (65.6%) had a positive reaction to either PPL or MDM alone. Thirty-two patients had positive skin test reactions to penicillin G or another p-lactam antibiotic. Five patients in whom a negative result was obtained in skin tests had a positive reaction to oral challenge. CONCLUSIONS: Our results indicate that a new brand of determinants that is commercially available in Europe is a reliable and useful tool for the diagnosis of beta-lactam allergy. The new reagents are a safe alternative to the previously available brand. (Less)
Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Alergia a penicilina, Alergia a medicamentos, Determinantes mayores, Determinantes menores, PPL, MDM, Benzylpenicilloyl polylysine, Minor determinant mixture, Major determinants, Drug allergy, Penicillin allergy
in
Journal of Investigational Allergology & Clinical Immunology
volume
17
issue
4
pages
257 - 260
publisher
Hogrefe & Huber Publishers
external identifiers
  • pmid:17694698
ISSN
1698-0808
language
English
LU publication?
no
id
743a71b2-a6ad-442d-9422-a74ba0636b21 (old id 1138245)
alternative location
http://www.jiaci.org/issues/vol17issue04/8.pdf
date added to LUP
2008-08-19 09:41:21
date last changed
2016-06-29 09:03:50
@article{743a71b2-a6ad-442d-9422-a74ba0636b21,
  abstract     = {BACKGROUND: Skin testing with major and minor determinants of benzylpenicillin is recommended standard practice for the evaluation of patients with immediate hypersensitivity reactions to beta-lactams. However, commercial reagents for this purpose were recently dropped from the European market. OBJECTIVE: In the present study, we assessed a new brand of reagents for use in skin testing in patients with suspected penicillin allergy. METHODS: Prick tests and intradermal tests were performed with benzylpenicilloyl polylysine (PPL) and minor determinant mixture (MDM). Penicillin G, amoxicillin, and the culprit beta-lactam were also tested. If skin tests were negative, a single-blind oral challenge test was performed with the culprit active principle or penicillin. If both skin tests and challenge tests were negative, the same procedure was repeated between 2 and 4 weeks later. RESULTS: A total of 636 patients were assessed. The allergy study was positive in 69 patients. Skin tests with PPL were positive in 30 patients (46.8%) and with MDM in 28 (43.7%). Sixteen patients displayed a positive reaction to both PPL and MDM (25%), while 42 patients (65.6%) had a positive reaction to either PPL or MDM alone. Thirty-two patients had positive skin test reactions to penicillin G or another p-lactam antibiotic. Five patients in whom a negative result was obtained in skin tests had a positive reaction to oral challenge. CONCLUSIONS: Our results indicate that a new brand of determinants that is commercially available in Europe is a reliable and useful tool for the diagnosis of beta-lactam allergy. The new reagents are a safe alternative to the previously available brand.},
  author       = {Matheu, Victor and Perez, E and Gonzalez, R and Poza, P and de la Torre, F and Sanchez-Machin, I and Garcia-Robaina, J C},
  issn         = {1698-0808},
  keyword      = {Alergia a penicilina,Alergia a medicamentos,Determinantes mayores,Determinantes menores,PPL,MDM,Benzylpenicilloyl polylysine,Minor determinant mixture,Major determinants,Drug allergy,Penicillin allergy},
  language     = {eng},
  number       = {4},
  pages        = {257--260},
  publisher    = {Hogrefe & Huber Publishers},
  series       = {Journal of Investigational Allergology & Clinical Immunology},
  title        = {Assessment of a new brand of determinants for skin testing in a large group of patients with suspected beta-lactam allergy},
  volume       = {17},
  year         = {2007},
}