RT Journal Article
T1 Resensitization in suspected penicillin allergy
A1 Doña, Inmaculada
A1 Guidolin, Lucia
A1 Bogas Herrera, Gádor
A1 Olivieri, Elisa
A1 Labella, Marina
A1 Schiapolli, Michele
A1 Saenz de Santa María-García, Rocío
A1 Dama, Annarita
A1 Salas, María
A1 Senna, Gianenrico
A1 Bonadonna, Patrizia
A1 Torres-Jaén, María Josefa
K1 Anafilaxia
AB The diagnosis of allergic reactions to penicillins (AR-PEN) is very complex as there is a loss of sensitization over time, which leads to negative skin tests (STs) and specific IgE in serum, and even to tolerance to the drug involved. However, STs may become positive after subsequent exposure to the culprit drug (resensitization), with the risk of inducing potentially severe reactions. The exact rate of resensitization to penicillins is unknown, ranging from 0% to 27.9% in published studies.ObjectivesTo analyze the rate of resensitization in patients with suggestive AR-PEN by repeating STs (retest) after an initial evaluation (IE).Material and MethodsPatients with suspected AR-PEN were prospectively evaluated between 2017 and 2020. They underwent STs, and a randomized group also underwent a drug provocation test (DPT) with the culprit. Only patients with negative STs and/or DPT were included. All included cases were retested by STs at 2–8 weeks.ResultsA total of 545 patients were included: 296 reporting immediate reactions (IRs) and 249 non-immediate reactions (NIRs). Eighty (14.7%) cases had positive results in retest (RT+): 63 (21.3%) IRs and 17 (6.8%) NIRs (p < 0.0001). The rate of RT+ was higher in anaphylaxis compared with all other reactions (45.8% vs 9.1%, p < 0.0001). The risk of RT+ was higher from the fifth week after IE (OR: 4.64, CI: 2.1–11.6; p < 0.001) and increased with the patient's age (OR: 1.02; CI: 1.01–1.04; p = 0.009).ConclusionsDue to the high rate of resensitization, retest should be included in the diagnostic algorithm of IRs to penicillins after an initial negative study, especially in anaphylaxis, to avoid potentially severe reactions after subsequent prescriptions of these drugs.
PB Wiley
YR 2022
FD 2022-09-06
LK https://hdl.handle.net/10630/25783
UL https://hdl.handle.net/10630/25783
LA eng
NO Doña, I, Guidolin, L, Bogas, G, et al. Resensitization in suspected penicillin allergy. Allergy. 2023; 78: 214- 224. doi: 10.1111/all.15508
NO The present study has been supported by Institute of Health “Carlos III” of the Ministry of Economy and Competitiveness (grants cofunded by European Regional Development Fund (ERDF): PI18/00095, RETIC ARADYAL RD16/0006/0001). Andalusian Regional Ministry of Economy and Knowledge (grants cofunded by European Regional Development Fund (ERDF): CTS-06603); Andalusian Regional Ministry Health (grants PI-0241-2016 and PE-0172-2018). GB holds a “Juan Rodes” (JR18/00054), Institute of Health “Carlos III” of the Ministry of Economy and Competitiveness (grants cofunded by European Social Fund [ESF]). ID is a Clinical Investigator (B-0001-2017), Andalusian Regional Ministry Health.
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 19 ene 2026