Allergy Asthma Respir Dis.  2017 Sep;5(5):239-247. 10.4168/aard.2017.5.5.239.

KAAACI Standardization Committee Report on the procedures and applications of the diagnostic tests for drug allergy

• Yang MS
• Ban GY
• Kim MH
• Lim KH
• Kwon HS
• Song WJ
• Jung JW
• Lee J
• Suh DI
• Kwon JW
• Kim SH
• Shin YS
• Kang HR
• Kim TB
• Lee BJ
• Lee AY
• Park HS
• Cho SH
• Korean Academy of Asthma, Allergy and Clinical Immunology Standardization Committee

• KMID: 2392398
• DOI: http://doi.org/10.4168/aard.2017.5.5.239

Abstract

Diagnostic methods for drug allergy include the patient's history, in vivo skin test, in vitro laboratory test, and provocation test. However, the history is often not reliable, procedures for in vivo and in vitro tests are not standardized, and provocation tests are sometimes harmful to patients. Generally, skin prick and intradermal tests are useful for immediate reactions; in contrast, patch test and delayed reading of both skin prick and intradermal tests are helpful for delayed reactions. A drug provocation test is the gold standard for both responses, and it is necessary to be aware of exact indications and contraindications with appropriate drugs, doses, and intervals. To date, several methods have been developed to detect culprit agents for drug hypersensitivity reactions, but they are neither completely well validated nor standardized. Based on this awareness and necessity, the Korean Academy of Asthma, Allergy and Clinical Immunology launched the Standardization Committee to review the international guidelines and the literature, and then developed the consensus report on the procedures and applications of diagnostic tests for drug allergy.

Keyword

Drug hypersensitivity; Skin tests; Intradermal tests; Patch tests

MeSH Terms

Allergy and Immunology
Asthma
Consensus
Diagnostic Tests, Routine*
Drug Hypersensitivity*
Humans
Hypersensitivity
In Vitro Techniques
Intradermal Tests
Patch Tests
Skin
Skin Tests

Figure

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  Fig. 1. Diagnostic flow for semisynthetic penicillin allergy. BP, benzylpenicillin; AX, amoxicillin.

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  Fig. 2. Diagnostic flow for patients with beta-lactam allergy before administering other beta-lactam antibiotics (modified from reference 8). For penicillin allergic patient before using cephalosporin (A), for cephalosporin allergic patient before using penicillin (B), and for cephalosporin allergic patient before using other cephalosporin (C).

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