Currently Available Skin Tests For Amoxicillin Allergy in Children Not Reliable

MedicalResearch.com Interview with:

Moshe Ben-Shoshan, MD, M.Sc. Assistant Professor Division of Pediatric Allergy and Clinical Immunology Department of Pediatrics McGill University Health Center Montreal, Quebec, Canada

Dr. Moshe Ben-Shoshan

Moshe Ben-Shoshan, MD, M.Sc.
Assistant Professor
Division of Pediatric Allergy and Clinical Immunology
Department of Pediatrics
McGill University Health Center
Montreal, Quebec, Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Ben-Shoshan: Given that up to 10% of children treated with amoxicillin are tagged as allergic usually with no confirmatory tests (given high waiting times to see an allergist and controversy regarding confirmatory tests) we aimed to assess the accuracy of the graded provocation challenge (PC) . Unlike previous studies we challenged ALL 818 children presenting with rashes on amoxicillin treatment .

We were able to show that almost 95% tolerated the challenge while 17 had immediate reactions (within 1 hour ) and 31 had non immediate reactions .

We found that although it is suggested to do skin tests ( with PrePen and pen G ) to diagnose immediate amoxicillin allergy only 1 of 17 had a positive skin test indicating poor sensitivity of this test. In addition among all those with negative challenge that we followed over 3 years 10% had mild skin reactions when they received subsequent full treatment .

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Ben-Shoshan: Our study suggests that in children presenting with a rash during amoxicillin treatment the  graded provocation challenge done in the appropriate setting by an allergist  is an accurate and effective strategy to diagnose amoxicillin allergy and that the currently available skin tests are redundant.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Ben-Shoshan: Future studies are required to assess factors associated with specific graded provocation challenge outcomes in children and in adults, and in particular researchers should investigate specific association with genetic markers to accurately determine future risk for antibiotic allergic reactions. 

MedicalResearch.com: Is there anything else you would like to add?

Dr. Ben-Shoshan: I would like to thank the MUHC research institute and the Montreal Children’s Hospital for their support in this research.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Christopher Mill, Marie-Noël Primeau, Elaine Medoff, Christine Lejtenyi, Andrew O’Keefe, Elena Netchiporouk, Alizee Dery, Moshe Ben-Shoshan. Assessing the Diagnostic Properties of a Graded Oral Provocation Challenge for the Diagnosis of Immediate and Nonimmediate Reactions to Amoxicillin in Children. JAMA Pediatrics, 2016; e160033 DOI:10.1001/jamapediatrics.2016.0033

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

Moshe Ben-Shoshan, MD, M.Sc. (2016). Currently Available Skin Tests For Axoxicillin Allergy in Children Not Reliable MedicalResearch.com

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.