ArticleThe journal of allergy and clinical immunology. In practice
The Combined Utility of Ex Vivo IFN-γ Release Enzyme-Linked ImmunoSpot Assay and In Vivo Skin Testing in Patients with Antibiotic-Associated Severe Cutaneous Adverse Reactions.
Article in The journal of allergy and clinical immunology. In practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 69 citations in OpenAlex.
- Evaluation of drug causality in SJS/TEN: The role of the lymphocyte transformation test and conventional/modified IFN-γ ELISpot assays.The World Allergy Organization journal · 2026Article
- In vitro diagnostics of drug hypersensitivity reactions.Allergologie select · 2026Review
- Utility of IFN-γ Enzyme-Linked Immunospot as Adjunctive Diagnostic for Severe T Cell-Mediated Reactions to Cotrimoxazole in High HIV and Tuberculosis Settings.The journal of allergy and clinical immunology. In practice · 2025Article
- Management of patients with tuberculosis medication-induced drug reaction with eosinophilia and systemic symptoms.Current opinion in allergy and clinical immunology · 2025Review
- Drug allergy.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2025Review
- Exploring cytokine outputs forThe World Allergy Organization journal · 2024Article
- Cephalosporin Allergy: Updates on Diagnostic Testing.Current allergy and asthma reports · 2024Review
- Knowledge mapping and global trends of drug hypersensitivity from 2013 to 2023: A bibliometric analysis.Immunity, inflammation and disease · 2024Article
- Tools for Etiologic Diagnosis of Drug-Induced Allergic Conditions.International journal of molecular sciences · 2023Review
- Post-acute phase and sequelae management of epidermal necrolysis: an international, multidisciplinary DELPHI-based consensus.Orphanet journal of rare diseases · 2023Article
- Study protocol: Australasian Registry of Severe Cutaneous Adverse Reactions (AUS-SCAR).BMJ open · 2022Article
- Immediate and Delayed Hypersensitivity Reactions to Beta-Lactam Antibiotics.Clinical reviews in allergy & immunology · 2022Review
- The assessment of severe cutaneous adverse drug reactions.Australian prescriber · 2022Review
- Sutton's law and severe cutaneous adverse drug reactions: Is the money in the blister?The journal of allergy and clinical immunology. Global · 2022Article
- Blister fluid as a cellular input forThe journal of allergy and clinical immunology. Global · 2022Article
- Tools to improve the diagnosis and management of T-cell mediated adverse drug reactions.Frontiers in medicine · 2022Review
- Severe Cutaneous Adverse Reactions to Anti-tuberculosis Drugs in Korean Patients.Allergy, asthma & immunology research · 2021Article
- Updates and Insights in the Diagnosis and Management of DRESS Syndrome.Current dermatology reports · 2021Review
- Dose Dependent Antimicrobial Cellular Cytotoxicity-Implications forFrontiers in pharmacology · 2021Article
- Current Pharmacogenetic Perspective on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.Frontiers in pharmacology · 2021Review
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundFor severe cutaneous adverse reactions (SCARs) associated with multiple antibiotics dosed concurrently, clinical causality is challenging and diagnostic approaches are limited, leading to constricted future antibiotic choices.
objectiveTo examine the combined utility of in vivo and ex vivo diagnostic approaches at assigning drug causality in a cohort of patients with antibiotic-associated (AA)-SCARs.
methodsPatients with AA-SCARs were prospectively recruited between April 2015 and February 2017. In vivo testing (patch testing or delayed intradermal testing) was performed to the implicated antibiotic(s) at the highest nonirritating concentration and read at 24 hours through 1 week. Ex vivo testing used patient peripheral blood mononuclear cells (PBMCs) stimulated with a range of pharmacologically relevant concentrations of implicated antibiotics to measure dose-dependent IFN-γ release from CD4+ and CD8+ T cells via an enzyme-linked immunoSpot assay.
resultsIn 19 patients with AA-SCARs, combined in vivo and ex vivo testing assigned antibiotic causality in 15 (79%) patients. Ten patients (53%) with AA-SCARs were positive on IFN-γ release enzyme-linked immunoSpot assay, with an overall reported sensitivity of 52% (95% CI, 29-76) and specificity of 100% (95% CI, 79-100), with improved sensitivity noted in acute (within 1 day to 6 weeks after SCAR onset) testing (75%) and in patients with higher phenotypic scores (59%). There was increased use of narrow-spectrum beta-lactams and antibiotics from within the implicated class following testing in patients with a positive ex vivo or in vivo test result.
conclusionsWe demonstrate the potential utility of combined in vivo and ex vivo testing in patients with AA-SCARs to assign drug causality with high specificity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.