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