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Medientyp:
E-Artikel
Titel:
EAACI/ENDA position paper on drug provocation testing
Beteiligte:
Barbaud, Annick;
Garvey, Lene Heise;
Torres, Maria;
Laguna, Jose Julio;
Arcolaci, Alessandra;
Bonadonna, Patrizia;
Scherer Hofmeier, Kathrin;
Chiriac, Anca Mirela;
Cernadas, Josefina;
Caubet, Jean Christoph;
Brockow, Knut
Erschienen:
Wiley, 2024
Erschienen in:Allergy
Sprache:
Englisch
DOI:
10.1111/all.15996
ISSN:
0105-4538;
1398-9995
Entstehung:
Anmerkungen:
Beschreibung:
<jats:title>Abstract</jats:title><jats:p>In drug hypersensitivity, drug provocation testing (DPT), also called drug challenge, is the gold standard for investigation. In recent years, risk stratification has become an important tool for adjusting the diagnostic strategy to the perceived risk, whilst still maintaining a high level of safety for the patient. Skin tests are recommended before DPT but may be omitted in low‐risk patients. The task force suggests a strict definition of such low‐risk patients in children and adults. Based on experience and evidence from studies of allergy to beta‐lactam antibiotics, an algorithm on how to adjust DPT to the risk, and when to omit skin tests before DPT, is presented. For other antibiotics, non‐steroidal anti‐inflammatory drugs and other drugs, skin tests are poorly validated and DPT is frequently necessary. We recommend performing DPT with chemotherapeutics and biologicals to avoid unnecessary desensitization procedures and DPT with skin tests negative contrast media. We suggest DPT with anesthetics only in highly specialized centers. Specifics of DPT to proton pump inhibitors, anticonvulsants and corticosteroids are discussed. This position paper provides general recommendations and guidance on optimizing use of DPT, whilst balancing benefits with patient safety and optimizing the use of the limited available resources.</jats:p>