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[Skin tests with high and minor determinants in patients with doubtful allergy to penicillin]
J J López Tiro1, M Orea Solano, G Flores Sandoval
1Hospital Regional Lic. Adolfo López Mateos, ISSSTE, México, DF.
Background:
Currently, the skin tests are the most accepted methods for the diagnosis of allergy to penicillin.
Objective:
To evaluate the efficacy and diagnosis security of the skin tests with high and minor determinants of penicillin, crystalline and penicillin, in patients with hypersensitivity reaction to penicillin.
Methods:
Patients with doubtful antecedents of reaction to penicillin (problem group) and healthy patients (control group) were included. Both groups were submitted at the following tests: 1) Skin tests with high and minor determinants of penicillin, and crystalline penicillin, by prick and intradermoreaction methods. 2) In case of negativity, tests of direct challenge with penicillin were practiced. The formation of wheal with or without erythema 3 mm related to the negative control or systemic reaction, was considered positive test.
Results:
47 patients were included (24 for problem group, and 23 for control group), 50% of the group problem showed positive reactions with the method of prick, none patient of the control group (p < 0.001); with the intradermoreaction method, 79% in the problem group and only 13.4% in the control group showed positive reaction (p < 0.001). Cutaneous tests showed local adverse effects. Clinical history showed a sensitivity or 88%, method of prick, 50%, and intradermoreaction method, 95%.
