RT Book, Section
A1 Manno, Rebecca L.
A1 Yazdany, Jinoos
A1 Tarrant, Teresa K.
A1 Kwan, Mildred
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1193126200
T1 Adverse Drug Reactions
T2 Current Medical Diagnosis & Treatment 2023
YR 2023
FD 2023
PB McGraw-Hill Education
PP New York, NY
SN 9781264687343
LK accessmedicine.mhmedical.com/content.aspx?aid=1193126200
RD 2024/04/24
AB Prick  skin  testing  for  most  low-molecular-weight  drugs  is  not  validated  and  is  interpretable  only  if  the  test  is  positive  at  a  nonirritating  concentration.  Testing  for  IgE-mediated  allergy  to  penicillin  (PCN)  is  validated;  skin  testing  with  the  metabolic  determinants  of  PCN  has  a  high  (more  than  98%)  negative  predictive  value.  Referral  of  individuals  with  a  listed  PCN  allergy  to  an  allergist  for  evaluation  is  worthwhile  because  more  than  90%  have  either  lost  sensitization  or  do  not  have  a  true  PCN  allergy.  Such  patients  may  then  safely  receive  beta-lactam  antibiotics,  including  penicillins  and  cephalosporins.  Allergy  testing  to  non-PCN  drugs  is  more  limited  because  it  is  either  not  standardized  in  practice  or  in  reagent  preparation,  or  the  reaction  may  not  be  IgE-mediated;  an  allergist  may  provide  guidance  about  the  likelihood  and  severity  of  future  exposures  to  determine  whether  re-challenging  with  the  drug  would  be  advisable.