Allergy Asthma Respir Dis.  2023 Apr;11(2):77-81. 10.4168/aard.2023.11.2.77.

Current practice of antibiotics skin test in pediatric inpatients: A single-center experience

• Roh YY
• Kim H
• Park M
• Kim SY
• Kim JD
• Kim MJ
• Lee YJ
• Kim YH
• Kim KW
• Sohn MH

• KMID: 2541972
• DOI: http://doi.org/10.4168/aard.2023.11.2.77

Abstract

Background
Routine practice of antibiotic skin test (AST) before administering antibiotics is with little scientific basis. However, AST is frequently performed in real-world practice. We aimed to explore the current practice status of AST.
Methods
All admission cases in Severance Hospital between January 2019 and December 2020 of patients at less than 19 years of age were collected retrospectively. AST results for 4 penicillins (ampicillin, ampicillin-sulbactam, amoxicillin-clavulanate, and piperacillin-tazobactam) and 6 cephalosporins (cefazolin, cefotaxime, cefotiam, cefpiramide, ceftriaxone, and flomoxef) as well as adverse drug reaction (ADR) reports were collected.
Results
Among 36,381 hospitalization cases, 7,589 and 16,468 were administered penicillins and cephalosporins, respectively. Penicillins were administered without AST in 2,622 cases (35%), 2 (0.08%) of which showed ADR. Of the remaining 4,967 cases who received AST, 57 (1.1%) showed a positive reaction. For cephalosporins, 15,473 cases (94%) received antibiotics without AST. Among them, 17 cases (0.1%) showed ADRs. For 995 cases that rceived AST, 22 (2.2%) revealed a positive reaction. Among 79 cases who were AST positive, 10 took the original medication.
Conclusion
The current practice of AST reveals heterogeneous and inconsistent patterns. This brings the need for a standardized guideline for the safe and effective use of antibiotics.

Keyword

Skin tests; Penicillins; Cephalosporins