Table 3.
Safety of skin tests in 459 patients and in 288 drug challenges.
| Positive Skin tests | Positive Challenges | ||
|---|---|---|---|
| Beta-lactam n (%) | 3/459† (0.7) | Beta-lactam n (%) | 9/288 § (3.1) |
| Prick | 1 (0.2) | Immediate | 4 (1.4) |
| IDR | 3 (0.7) | Delayed | 5 (1.7) |
| Penicillin | 2/423‡ (0.5) | Penicillin | 8/228 (3.5) |
| Prick | 1 (0.2) | Immediate | 4 (1.7) |
| Generalised urticaria‡ | 1 (0.2) | Grade I (hives) | 2 (0.9) |
| IDR | 2 (0.5) | Grade III (bronchospasm) | 1 (0.4) |
| Generalised urticaria‡ | 1 (0.2) | Grade IV (shock) | 1 (0.4) |
| Bronchospasm | 1 (0.2) | Delayed | 4 (1.7) |
| Cutaneous reaction¶ | 3 (1.3) | ||
| Hypersensitivity of type III¶¶ | 1 (0.4) | ||
| Cephalosporin | 1/295 (0.3) | Cephalosporin | 1/60 (1.7) |
| Prick | 0 | Hypersensitivity of type III¶¶¶ | 1 (1.7) |
| IDR | 1 (0.3) | ||
| Malaise and hypotension | 1 (0.3) | ||
459 patients underwent skin tests for beta-lactam antibiotics, several of them were tested for different subclasses (penicillins and/or cephalosporins).
1 patient developed generalized skin hives after prick and intradermal skin tests to amoxicillin/clavulanate.
288 challenges were performed: 12 negative direct drug challenges (10 with a penicillin and 2 with a cephalosporin) without prior skin testing and 276 challenges were preceded by negative skin testing. The decision to proceed with a direct drug challenge (i.e., without prior skin testing) was based on the physician's assessment because the risk of a reaction was highly unlikely.
2 maculopapular eruptions occurred 6 and 12 h after a single dose-challenge, and one occurred on day 2 of a 3-day challenge
This patient developed incomplete serum sickness with generalized urticarial 10 h after a single-dose challenge.
This patient developed arthromyalgia with cutaneous maculopapular eruption 6 h after a single-dose challenge.