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Drug provocation testing: risk stratification is key.
- Source :
-
Current opinion in allergy and clinical immunology [Curr Opin Allergy Clin Immunol] 2019 Aug; Vol. 19 (4), pp. 266-271. - Publication Year :
- 2019
-
Abstract
- Purpose of Review: This review aims to describe current best practice and recent advances in the use of risk stratification as a tool for drug provocation testing (DPT). In particular, we focus on the testing of unsubstantiated penicillin allergy labels.<br />Recent Findings: The inherent risks of DPT are mitigated through careful selection of patients. A detailed history will elicit features of a potentially severe index reaction, as well as significant patient comorbidities which may increase the risks associated with DPT. Such patients require skin testing and/or in vitro testing prior to consideration for a DPT. However, there is increasing evidence that patients without these features may be able to proceed directly to DPT. This has been demonstrated extensively with unsubstantiated penicillin allergy labels, and a variety of risk stratification models have been employed to identify the 'low-risk' patient. Improved outcomes and reduced cost have been demonstrated with such models without compromising patient safety.<br />Summary: Risk stratification tools may enable well-tolerated and effective 'delabelling' of low-risk patients, with less demand on already scarce resources.
Details
- Language :
- English
- ISSN :
- 1473-6322
- Volume :
- 19
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Current opinion in allergy and clinical immunology
- Publication Type :
- Academic Journal
- Accession number :
- 31247633
- Full Text :
- https://doi.org/10.1097/ACI.0000000000000543