Allergy Asthma Respir Dis.  2017 Sep;5(5):239-247. 10.4168/aard.2017.5.5.239.

KAAACI Standardization Committee Report on the procedures and applications of the diagnostic tests for drug allergy

Affiliations
  • 1Department of Internal Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea.
  • 2Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea. drsys93@naver.com
  • 3Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
  • 4Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea.
  • 5Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 6Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
  • 8Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 9Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
  • 10Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
  • 11Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 12Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 13Department of Dermatology, Dongguk University Ilsan Hospital, Goyang, Korea.

Abstract

Diagnostic methods for drug allergy include the patient's history, in vivo skin test, in vitro laboratory test, and provocation test. However, the history is often not reliable, procedures for in vivo and in vitro tests are not standardized, and provocation tests are sometimes harmful to patients. Generally, skin prick and intradermal tests are useful for immediate reactions; in contrast, patch test and delayed reading of both skin prick and intradermal tests are helpful for delayed reactions. A drug provocation test is the gold standard for both responses, and it is necessary to be aware of exact indications and contraindications with appropriate drugs, doses, and intervals. To date, several methods have been developed to detect culprit agents for drug hypersensitivity reactions, but they are neither completely well validated nor standardized. Based on this awareness and necessity, the Korean Academy of Asthma, Allergy and Clinical Immunology launched the Standardization Committee to review the international guidelines and the literature, and then developed the consensus report on the procedures and applications of diagnostic tests for drug allergy.

Keyword

Drug hypersensitivity; Skin tests; Intradermal tests; Patch tests

MeSH Terms

Allergy and Immunology
Asthma
Consensus
Diagnostic Tests, Routine*
Drug Hypersensitivity*
Humans
Hypersensitivity
In Vitro Techniques
Intradermal Tests
Patch Tests
Skin
Skin Tests

Figure

  • Fig. 1. Diagnostic flow for semisynthetic penicillin allergy. BP, benzylpenicillin; AX, amoxicillin.

  • Fig. 2. Diagnostic flow for patients with beta-lactam allergy before administering other beta-lactam antibiotics (modified from reference 8). For penicillin allergic patient before using cephalosporin (A), for cephalosporin allergic patient before using penicillin (B), and for cephalosporin allergic patient before using other cephalosporin (C).


Cited by  2 articles

Adverse drug reactions
Min-Kyung Cho, Dong Yoon Kang, Hye-Ryun Kang
J Korean Med Assoc. 2019;62(9):472-479.    doi: 10.5124/jkma.2019.62.9.472.

Drug provocation tests in children
Yang Park
Allergy Asthma Respir Dis. 2018;6(1):1-3.    doi: 10.4168/aard.2018.6.1.1.


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