PMID- 31923549
OWN - NLM
STAT- MEDLINE
DCOM- 20200513
LR  - 20200513
IS  - 1534-4436 (Electronic)
IS  - 1081-1206 (Linking)
VI  - 124
IP  - 5
DP  - 2020 May
TI  - The negative predictive value of 5-day drug provocation test in nonimmediate 
      beta-lactam allergy in children.
PG  - 494-499
LID - S1081-1206(20)30004-1 [pii]
LID - 10.1016/j.anai.2019.12.029 [doi]
AB  - BACKGROUND: Extending the drug provocation test (DPT) period is recommended for 
      patients with suspected nonimmediate beta-lactam antibiotic (BLA) allergy and 
      negative DPT. No consensus has been reached regarding the duration of prolonged 
      provocation. OBJECTIVE: We aimed to determine the negative predictive value (NPV) 
      of the 5-day extended DPT. METHODS: Parents of patients with suspected 
      nonimmediate mild cutaneous reactions with BLAs who had been subjected to 5-day 
      DPT with culprit drugs were questioned by telephone interview about reexposure to 
      the tested drug. Patients with reported reaction during reexposure were 
      reevaluated. Skin tests and serum-specific immunoglobulin E (IgE) analysis were 
      not performed before first DPT. RESULTS: A total of 355 patients had negative 
      results in 5-day DPT. The median age at DPT was 4.2 years, and 52.9% were male. 
      The families of 255 patients (72%) could be contacted. Of these 255 patients, 179 
      (70%) had used the same drug, and reactions were reported for 6 (3.4%) of those 
      patients, who were subsequently reevaluated. Five of the 6 patients had DPT with 
      amoxicillin-clavulanate and 1 with cefixime. When detailed history was taken, 2 
      of the 5 patients with amoxicillin-clavulanate reaction were found to have used 
      the drug unintentionally after their reaction to reexposure and did not have any 
      symptoms. One of the patients underwent allergy workup and tested negative, and 
      the other 2 refused the test. The patient with reported cefixime reaction 
      underwent repeated allergy workup and tested negative. Therefore, the NPV of 
      5-day prolonged DPT was 98.9%. CONCLUSION: The 5-day prolonged DPT has high NPV 
      and seems appropriate in duration for children with suspected nonimmediate-BLA 
      allergy.
CI  - Copyright (c) 2020 American College of Allergy, Asthma & Immunology. Published by 
      Elsevier Inc. All rights reserved.
FAU - Kulhas Celik, Ilknur
AU  - Kulhas Celik I
AD  - University of Health Sciences, Ankara Child Health and Diseases Hematology 
      Oncology Training and Research Hospital, Division of Pediatrics Allergy and 
      Immunology, Ankara, Turkey. Electronic address: dr.ilknur-46@windowslive.com.
FAU - Guvenir, Hakan
AU  - Guvenir H
AD  - University of Health Sciences, Ankara Child Health and Diseases Hematology 
      Oncology Training and Research Hospital, Division of Pediatrics Allergy and 
      Immunology, Ankara, Turkey.
FAU - Hurmuzlu, Selen
AU  - Hurmuzlu S
AD  - University of Health Sciences, Ankara Child Health and Diseases Hematology 
      Oncology Training and Research Hospital, Division of Pediatrics, Ankara, Turkey.
FAU - Toyran, Muge
AU  - Toyran M
AD  - University of Health Sciences, Ankara Child Health and Diseases Hematology 
      Oncology Training and Research Hospital, Division of Pediatrics Allergy and 
      Immunology, Ankara, Turkey.
FAU - Civelek, Ersoy
AU  - Civelek E
AD  - University of Health Sciences, Ankara Child Health and Diseases Hematology 
      Oncology Training and Research Hospital, Division of Pediatrics Allergy and 
      Immunology, Ankara, Turkey.
FAU - Kocabas, Can Naci
AU  - Kocabas CN
AD  - Division of Pediatric Allergy and Immunology, Department of Children's Health and 
      Diseases, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
FAU - Dibek Misirlioglu, Emine
AU  - Dibek Misirlioglu E
AD  - University of Health Sciences, Ankara Child Health and Diseases Hematology 
      Oncology Training and Research Hospital, Division of Pediatrics Allergy and 
      Immunology, Ankara, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20200107
PL  - United States
TA  - Ann Allergy Asthma Immunol
JT  - Annals of allergy, asthma & immunology : official publication of the American 
      College of Allergy, Asthma, & Immunology
JID - 9503580
RN  - 0 (Allergens)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (beta-Lactams)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 74469-00-4 (Amoxicillin-Potassium Clavulanate Combination)
RN  - 97I1C92E55 (Cefixime)
SB  - IM
MH  - Administration, Oral
MH  - Allergens/immunology
MH  - Amoxicillin-Potassium Clavulanate Combination/adverse 
      effects/immunology/*therapeutic use
MH  - Anti-Bacterial Agents/adverse effects/immunology/*therapeutic use
MH  - Cefixime/adverse effects/*therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Drug Hypersensitivity/*diagnosis
MH  - Female
MH  - Humans
MH  - Hypersensitivity, Delayed
MH  - Immunization/*methods
MH  - Immunoglobulin E/metabolism
MH  - Infant
MH  - Male
MH  - Predictive Value of Tests
MH  - *Time Factors
MH  - beta-Lactams/adverse effects/immunology/*therapeutic use
EDAT- 2020/01/11 06:00
MHDA- 2020/05/14 06:00
CRDT- 2020/01/11 06:00
PHST- 2019/08/24 00:00 [received]
PHST- 2019/12/27 00:00 [revised]
PHST- 2019/12/31 00:00 [accepted]
PHST- 2020/01/11 06:00 [pubmed]
PHST- 2020/05/14 06:00 [medline]
PHST- 2020/01/11 06:00 [entrez]
AID - S1081-1206(20)30004-1 [pii]
AID - 10.1016/j.anai.2019.12.029 [doi]
PST - ppublish
SO  - Ann Allergy Asthma Immunol. 2020 May;124(5):494-499. doi: 
      10.1016/j.anai.2019.12.029. Epub 2020 Jan 7.