Negative predictive value of drug provocation tests in children

Background The negative predictive value of the drug provocation test is important for both the patient and the physician. However, in children, this predictive value is unresolved. Methods The study included patients who had drug provocation test with a suspected drug and was diagnosed as ‘not alle...

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Published in:Pediatric allergy and immunology 2014-11, Vol.25 (7), p.685-690
Main Authors: Misirlioglu, Emine D., Toyran, Muge, Capanoglu, Murat, Kaya, Aysenur, Civelek, Ersoy, Kocabas, Can N.
Format: Article
Language:English
Subjects:
Administration, Oral
Adolescent
Allergens - immunology
Allergies
Anti-Bacterial Agents - immunology
Anti-Inflammatory Agents, Non-Steroidal - immunology
beta-lactams
Child
Child, Preschool
drug hypersensitivity
Drug Hypersensitivity - diagnosis
drug provocation tests
Drug therapy
Female
Humans
Immunization - methods
Infant
Male
Medical tests
negative predictive value
nonsteroidal anti-inflammatory drugs
Predictive Value of Tests
resensitization
Side effects
Skin Tests
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Summary:Background The negative predictive value of the drug provocation test is important for both the patient and the physician. However, in children, this predictive value is unresolved. Methods The study included patients who had drug provocation test with a suspected drug and was diagnosed as ‘not allergic to the drug’. Three months after allergy workup, the patients were contacted and asked for reexposure to the tested drug. Patients who have reported reactions during reexposure were reevaluated with skin tests and drug provocation. Results During the study period, 217 provocations were performed to 203 patients. Of these, 163 patients (80.3%) with 175 negative drug provocation tests could be contacted. Ninety‐one (52%) of the 175 cases reported to use the tested drug again, and 11 (12%) of these cases declared that they had a new reaction. Two of the eleven cases refused reevaluation. Nine cases were evaluated by drug allergy workup. Two of the nine cases were classified as allergic after retests. Collectively, the negative predictive value was 95.6% (87 of 91 cases) for all drug challenges. Conclusions The negative predictive value of the drug provocation test is abundant in children; however, negative drug provocation tests do not necessarily predict tolerance for the drug.
ISSN:0905-6157
1399-3038
DOI:10.1111/pai.12286