Drug provocation testing: risk stratification is key.
Curr Opin Allergy Clin Immunol
; 19(4): 266-271, 2019 08.
Article
en En
| MEDLINE
| ID: mdl-31247633
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. 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. SUMMARY: Risk stratification tools may enable well-tolerated and effective 'delabelling' of low-risk patients, with less demand on already scarce resources.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Inmunización
/
Selección de Paciente
/
Hipersensibilidad a las Drogas
Tipo de estudio:
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Animals
/
Humans
Idioma:
En
Revista:
Curr Opin Allergy Clin Immunol
Asunto de la revista:
ALERGIA E IMUNOLOGIA
Año:
2019
Tipo del documento:
Article
Pais de publicación:
Estados Unidos