Assessment of a new brand of determinants for skin testing in a large group of patients with suspected beta-lactam allergy
(2007) In Journal of Investigational Allergology & Clinical Immunology 17(4). p.257-260- 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)
- 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)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1138245
- author
- Matheu, Victor LU ; Perez, E ; Gonzalez, R ; Poza, P ; de la Torre, F ; Sanchez-Machin, I and Garcia-Robaina, J C
- publishing date
- 2007
- 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
- scopus:34548266700
- 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
- 2016-04-01 12:14:32
- date last changed
- 2022-03-21 01:28:25
@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}},
keywords = {{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}},
url = {{http://www.jiaci.org/issues/vol17issue04/8.pdf}},
volume = {{17}},
year = {{2007}},
}