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Penicillin skin testing is a safe and effective tool for evaluating penicillin allergy in the pediatric population

Stephanie J Fox1, Miguel A Park1

  • 1Division of Allergic Diseases, Mayo Clinic, Rochester, Minn.

The Journal of Allergy and Clinical Immunology. in Practice
|July 15, 2014
PubMed

Insights

Penicillin skin testing is safe and effective for evaluating penicillin allergy in children. This study found no adverse reactions to the skin test itself, demonstrating its utility in pediatric allergy assessment.

Area of Science:

  • Pediatric Allergy and Immunology
  • Clinical Pharmacology
  • Diagnostic Testing

Background:

  • Penicillin skin testing is validated for adult penicillin allergy assessment.
  • Commercial penicillin skin test reagents (e.g., Pre-Pen) are not FDA-approved for pediatric use.
  • Limited data exists on the safety and validity of penicillin skin testing in children.

Purpose of the Study:

  • To evaluate the safety and effectiveness of penicillin skin testing in children with a history of penicillin allergy.
  • To compare the rate of positive penicillin skin tests in children versus adults.

Main Methods:

  • Children under 18 with a history of penicillin allergy underwent penicillin skin testing.
  • Demographics, skin test results, and subsequent reactions to penicillin or the skin test were recorded.
  • Chi-squared test was used to compare positive skin test rates between pediatric and adult populations.

Main Results:

  • Of 778 children tested, 8.5% had a positive skin test, and 1.1% had an equivocal result.
  • Children were significantly more likely to have a positive penicillin skin test compared to adults (8.5% vs. 3.6%).
  • No adverse reactions to the penicillin skin testing procedure were observed in any children.

Conclusions:

  • Penicillin skin testing is a safe diagnostic tool for evaluating penicillin allergy in pediatric patients.
  • The testing demonstrated effectiveness in identifying children with penicillin allergy.
  • Findings support the expanded use of penicillin skin testing in the pediatric population.
Abstract

Keywords:
Adverse drug reactionPediatricPenicillin allergyPenicillin skin testingSafe

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