Skin test concentrations for systemically administered drugs -- an ENDA/EAACI Drug Allergy Interest Group position paper
Knut Brockow,Lh Garvey,Werner Aberer,Marina Atanaskovic-Markovic,A. Barbaud,M. B. Bilò,Andreas J. Bircher,Miguel Blanca,B Bonadonna,Paolo Campi,E Castro,Jr Cernadas,Am Chiriac,Pascal Demoly,Martine Grosber,J Gooi,Carla Lombardo,Pm Mertes,Holger Mosbech,S Nasser,M. Pagani,J. Ring,Audrey Romano,Kathrin Scherer,B Schnyder,S. Testi,María José Torres,Axel Trautmann,Ingrid Terreehorst +28 more
TLDR
This work has performed a literature search on skin test drug concentration in MEDLINE and EMBASE, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation, and recommends drug concentration for skin testing aiming to achieve a specificity of at least 95%.Abstract:
Skin tests are of paramount importance for the evaluation of drug hypersensitivity reactions. Drug skin tests are often not carried out because of lack of concise information on specific test concentrations. The diagnosis of drug allergy is often based on history alone, which is an unreliable indicator of true hypersensitivity.To promote and standardize reproducible skin testing with safe and nonirritant drug concentrations in the clinical practice, the European Network and European Academy of Allergy and Clinical Immunology (EAACI) Interest Group on Drug Allergy has performed a literature search on skin test drug concentration in MEDLINE and EMBASE, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation. Where the literature is poor, we have taken into consideration the collective experience of the group.We recommend drug concentration for skin testing aiming to achieve a specificity of at least 95%. It has been possible to recommend specific drug concentration for betalactam antibiotics, perioperative drugs, heparins, platinum salts and radiocontrast media. For many other drugs, there is insufficient evidence to recommend appropriate drug concentration. There is urgent need for multicentre studies designed to establish and validate drug skin test concentration using standard protocols. For most drugs, sensitivity of skin testing is higher in immediate hypersensitivity compared to nonimmediate hypersensitivity.read more
Citations
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European Society of Contact Dermatitis guideline for diagnostic patch testing – recommendations on best practice
Jeanne D. Johansen,Kristiina Aalto-Korte,Tove Agner,Klaus Ejner Andersen,Andreas J. Bircher,Magnus Bruze,Alicia Cannavó,Ana Giménez-Arnau,Margarida Gonçalo,An Goossens,Swen M. John,Carola Lidén,Magnus Lindberg,Vera Mahler,Mihály Matura,Thomas Rustemeyer,Jørgen Serup,Radoslaw Spiewak,Jacob P. Thyssen,M. Vigan,Ian R. White,Mark Wilkinson,Wolfgang Uter +22 more
TL;DR: The present guideline summarizes all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact dermatitis or other delayed‐type hypersensitivity skin and mucosal conditions.
Journal ArticleDOI
International Consensus on drug allergy.
Pascal Demoly,N. F. Adkinson,Knut Brockow,Mariana Castells,Anca-Mirela Chiriac,Paul A. Greenberger,David A. Khan,David M. Lang,Hae-Sim Park,Werner J. Pichler,Mario Sánchez-Borges,Tetsuo Shiohara,Bernard Yu-Hor Thong +12 more
TL;DR: The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences and deficiencies of evidence, thus providing a comprehensive reference document for the diagnosis and management of DHRs.
Journal ArticleDOI
The clinical utility of basophil activation testing in diagnosis and monitoring of allergic disease
Hans Jürgen Hoffmann,Alexandra F. Santos,Cristobalina Mayorga,Anna Nopp,Bernadette Eberlein,Marta Ferrer,Paul Rouzaire,Didier G. Ebo,Vito Sabato,Maria L. Sanz,Tatjana Pecaric-Petkovic,Sarita U. Patil,Oliver Hausmann,Wayne G. Shreffler,Peter Korošec,Edward F. Knol +15 more
TL;DR: The nature of basophil activation as an ex vivo challenge makes it a multifaceted and promising tool for the allergist, and it ought to precede challenge testing.
Journal ArticleDOI
Management of allergy to penicillins and other beta‐lactams
R. Mirakian,Susan Leech,Mamidipudi T. Krishna,Alex G. Richter,Pia A. J. Huber,Sophie Farooque,N. Khan,Munir Pirmohamed,Andrew Clark,Shuaib Nasser +9 more
TL;DR: A guideline for the management of immediate and non‐immediate allergic reactions to penicillins and other beta‐lactams is intended for UK specialists in both adult and paediatric allergy and for other clinicians practising allergy in secondary and tertiary care.
Journal ArticleDOI
Drug hypersensitivity in children: report from the pediatric task force of the EAACI Drug Allergy Interest Group.
Eva Rebelo Gomes,Knut Brockow,Semanur Kuyucu,Francesca Saretta,Francesca Mori,Natalia Blanca-López,Hagen Ott,Marina Atanaskovic-Markovic,Mona Kidon,Jean-Christoph Roger J-P Caubet,Ingrid Terreehorst +10 more
TL;DR: An up‐to‐date review on epidemiology, clinical spectrum, diagnostic tools, and current management of DH in children focuses on reported differences between pediatric and adult patients, also identifying unmet needs to be addressed in further research.
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General considerations for skin test procedures in the diagnosis of drug hypersensitivity
TL;DR: This poster presents a poster presented at the European Congress of Allergy and Clinical Immunology/Allergology, entitled “Evaluating the immune defences of the immune system against fungal infections”.
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In Memoriam: Dr. Lois Lloyd and Dr. Ronald Casey
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Guidelines for performing skin tests with drugs in the investigation of cutaneous adverse drug reactions.
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