A suspicion of antibiotic allergy in children is often incorrect - allergy was confirmed only in 14%

Although allergy to antibiotics is commonly claimed, true allergy to these drugs is often absent http://buff.ly/1tIbcTl

IgE assays show low sensitivity and specificity for diagnosis of drug allergy. Oral provocation tests are considered the golden standard in proving the absence of antibiotic allergy.

The following protocol for an oral provocation test was suggested in JACI:

Oral provocation test

t = 0 min: skin contact (antibiotic suspension on skin)
t = 30 min: lip contact (antibiotic suspension on outside lip)
t = 60 min: mucosal contact (licking a spoon dipped in antibiotic suspension)
t = 90 min: administer dose orally (one third of half-day dose)
t =120 min: administer dose orally (two thirds of half-day dose)
t =180 min: physical examination by doctor (no problems: discharge)
If complaints occur during test: immediate physical examination by doctor

Classification of adverse reactions to drugs, using the "SOAP III" mnemonic (click to enlarge the image):


A suspicion of antibiotic allergy in children is often incorrect. Marjolein Mattheij, MD, Esther de Vries, MD. The Journal of Allergy and Clinical Immunology, Volume 129, Issue 2, Page 583, February 2012.

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