Patch Testing in Adverse Drug Reactions

Gonçalo, Margarida; Bruynzeel, Derk P.

doi:10.1007/978-3-319-72451-5_26-1

Cited by 5 publications

(7 citation statements)

References 121 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patch test were applied to the patients back and left in place for 48 h. Results were read using a semi-quantitative score from no reaction, to +, ++, +++ depending on the degree of skin reaction at 48 h, 72 h and 1 week post initial application. Concentrations were based on non-irritating concentrations for patch testing reported in the literature ( 15 , 16 ). Concentrations used for patch testing included: benzylpencillin 5% and 10%; penicillin VK 1%, 5%, 10%; amoxicillin 5%, 10%, and 25%; ampicillin 5%; flucloxacillin 1%, 5%, and 10%; cephalexin 5% and 10%; ceftriaxone 5% and 10%; cefepime 5%; cephazolin 5%; tazocin 5% and meropenem 5%.…”

Section: Methodsmentioning

confidence: 99%

Cross With Caution: Antibiotic Cross-Reactivity and Co-Reactivity Patterns in Severe Cutaneous Adverse Reactions

2021

View full text Add to dashboard Cite

Current understanding of cross-reactivity in severe cutaneous adverse reactions to beta-lactam antibiotics is limited, thereby making recommendations for future prescribing difficult. The underlying immunopathogenesis of these reactions is not completely understood but involves interactions between small molecule drugs, T cells and HLA molecules. Historically, these reactions were considered to be specific to the inciting antibiotic and therefore likely to have minimal cross-reactivity. We assessed patients presenting with non-SJS/TEN severe cutaneous adverse reactions to a tertiary hospital drug allergy clinic. In our case series cross-reactivity or co-reactivity commonly occurred among the beta-lactam antibiotic class, however further research is required to investigate and understand patterns of cross-reactivity. Based on our experience we provide clinicians with a practical algorithm for testing for cross-reactivity in non-SJS/TEN severe cutaneous adverse reactions.

show abstract

Section: Methodsmentioning

confidence: 99%

Cross With Caution: Antibiotic Cross-Reactivity and Co-Reactivity Patterns in Severe Cutaneous Adverse Reactions

2021

View full text Add to dashboard Cite

show abstract

“…From the studies presented thus far, no evidence for the optimal patch test concentration and vehicle for any drug has emerged and, therefore, some practical recommendations are given here, which also apply to other delayed-type drug hypersensitivity reactions. 4,[255][256][257] In the authorʼs opinion, patch testing should be the first diagnostic method in the search for the drug(s) that are responsible for cutaneous adverse drug reactions, with the possible exception of cases where patients with DRESS had used only allopurinol or sulfasalazine. Preferably, the pure drugs, not the commercialized tablets, used by the patients, should be tested to obtain well-defined test materials and to avoid falsepositive results (ie, not indicating hypersensitivity to the active drug material) due to hidden additives in the drug formulations, degradation products, or impurities.…”

Section: Optimal Patch Test Concentrations and Vehiclesmentioning

confidence: 99%

Patch testing in drug reaction with eosinophilia and systemic symptoms (DRESS): A literature review

Groot

2022

Contact Dermatitis

View full text Add to dashboard Cite

The literature on positive patch test results in drug reaction with eosinophilia and systemic symptoms (DRESS) is reviewed. One hundred and five drugs were identified that have together caused 536 positive patch tests in 437 DRESS patients. By far, the most reactions (n = 145) were caused by carbamazepine, followed by amoxicillin, isoniazid, phenytoin, ethambutol, fluindione, phenobarbital, rifampicin, and ceftriaxone; 43 drugs each caused a single case only. The drug classes causing the highest number of reactions were anticonvulsants (39%), beta‐lactam antibiotics (20%), antituberculosis agents (11%), non‐beta‐lactam antibiotics (6%), and iodinated contrast media (5%). The sensitivity of patch testing (percentage of positive reactions) is high for anticonvulsants (notably carbamazepine), beta‐lactam antibiotics (notably amoxicillin), and, possibly, iodinated contrast media. Allopurinol and sulfasalazine frequently cause DRESS but never give positive patch tests. Patch testing in DRESS appears to be safe, although mild recurrence of DRESS symptoms, mostly skin reactions, may not be rare. Multiple drug hypersensitivity was found to occur in 16% of all patients, but it is argued that the true frequency is higher. Clinical aspects of DRESS, including diagnosing the disease and identifying culprit drugs (patch tests, intradermal tests, in vitro tests, challenge tests) are also provided, emphasizing the role of patch testing.

show abstract

“…There are very exceptional reports of anaphylaxis when PT is incorrectly performed. 25 Only if PT results negative, the work-up continues with SPT and IDT. These have been recommended in mild ADR, while their application in severe ADR needs to be considered with caution and reserved when suspected drug is needful for the patient.…”

Section: Skin Testsmentioning

confidence: 99%