Diagnosis of reported beta-lactam hypersensitivity in different diagnostic risk groups

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Introduction: Beta-lactam (BL) antibiotics are one of the most common causes of drug hypersensitivity.Diagnosis of hypersensitivity to BL antibiotics includes: skin prick tests (SPT), intradermal tests (IDT), drug provocation tests (DPT) and allergen-specific IgE (sIgE) determination.Diagnostic methods of BL hypersensitivity remain the same for years.Aim: The aim of our study was to analyze the relevance of diagnostic methods in patients with reported BL allergy in different diagnostic risk groups. Material and methods:The database included a detailed medical history, laboratory test results and allergy work-up.263 patients were included in the study.The low-risk group consisted of 88 (33.46%) patients, moderate of 129 (49.05%) patients and 46 (17.49%) patients were classified to the high diagnostic risk group.Results: Diagnostic risk groups of hypersensitivity to BL antibiotics do not differ in laboratory results, including a specific IgE level.In 23 (8.7%) patients, hypersensitivity to BL antibiotics was confirmed regardless of the risk group.Among the patients with positive skin tests (10/263, 3.8%) or provocation test (13/263, 4.9%), 6 (2.3%) patients were diagnosed with hypersensitivity to the BL ring, 2 (0.76%) with cross-sensitivity between aminopenicillin, and amino-cephalosporin, 3 (1.14%)were diagnosed with hypersensitivity to two BL antibiotics from different groups, 12 (4.5%)had confirmed hypersensitivity to the reported BL antibiotic, including 6 (2.3%) diagnosed with IgE-independent hypersensitivity to the reported BL antibiotic.Conclusions: Diagnostic risk groups of hypersensitivity to BL antibiotics do not differ in laboratory results.Skin tests are useful in diagnosing hypersensitivity to BL antibiotics, but DPT remain the gold standard.

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