Safety of direct oral provocation testing using the Amoxicillin-2-step-challenge in children with history of non-immediate reactions to amoxicillin
Safety of direct oral provocation testing using the Amoxicillin-2-step-challenge in children with history of non-immediate reactions to amoxicillin
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Background: Previous studies have shown that direct oral provocation tests, without prior skin testing, in children having delayed onset, benign rashes to beta-lactam antibiotic is safe and effective.Although, this test is useful in confirming drug hypersensitivity reactions, there AEG IKE84471FB 78cm Induction Hob - Black is no standard protocol recommendation of drug provocation tests.This study aimed to evaluate the safety of the direct oral provocation test, using the Amoxicillin-2-step-challenge without prior skin testing, in children with history of non-immediate reactions to amoxicillin.
Methods: The Amoxicillin-2-step-challenge protocol was performed in children with history of non-immediate reactions to amoxicillin.This protocol is composed of 2 doses of amoxicillin, with a 30-min interval; continued for a total of 5 days.All of the patients had not undergone skin testing before the oral provocation test.
Results: This study included 54 children, having a median age of 6.6 years, with 70.4% being male.
Amoxicillin and amoxicillin-clavulanic acid were reported as the culprit drug in 75.9% and 24.1%, respectively.
The index reactions were maculopapular (MP) rash in 79.6% and delayed urticarial rash/angioedema in 20.4%.
Five patients (9.3%) had a reaction during the provocation test, all of these patients had delayed urticaria and were treated with oral antihistamine.However, 1 patient developed a fever alongside an MP rash.
Laboratory investigation for this patient showed increased atypical lymphocytes and liver enzymes elevation.Conclusions: Direct oral Course a pied - Accessoires - Hydratation - Ceinture provocation tests, using the Amoxicillin-2-step-challenge, without prior skin testing, revealed good, immediate safety for the diagnosis of amoxicillin hypersensitivity in children with history of non-immediate reactions to amoxicillin.