ArticleClinical and translational allergy2021
Frequency of severe reactions following penicillin drug provocation tests: A Bayesian meta-analysis.
Article in Clinical and translational allergy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Penicillin Allergy Testing and Delabeling for Patients Who Are Prescribed Penicillin: A Systematic Review for a World Health Organization Guideline.Clinical reviews in allergy & immunology · 2024Pooled it
- Guidelines for the management of adult penicillin allergy in community and specialist settings in Australia and New Zealand: An AGREE II and Delphi-based approach.The journal of allergy and clinical immunology. Global · 2026Article
- Drug Provocation Tests with Washout Intervals for Delayed Hypersensitivity Reactions: A Real-World Retrospective Analysis.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Penicillin allergy documentation in the UAE: 10-year trends and stewardship implications.Frontiers in medicine · 2026Article
- PEN-FAST in pediatrics: a reliable tool for penicillin allergy assessment?European journal of pediatrics · 2025Article
- Success of amoxicillin challenges in the emergency department for children with low risk of serious reactions.Paediatrics & child health · 2025Article
- Time to challenge penicillin allergy labels.Canadian family physician Medecin de famille canadien · 2025Article
- Subtype prevalence and treatment implication in adolescents and adults with mild-to-moderate asthma: Systematic review and meta-analysis.The journal of allergy and clinical immunology. Global · 2025Article
- How to Define and Manage Low-Risk Drug Allergy Labels.The journal of allergy and clinical immunology. In practice · 2024Review
- The state and consideration for skin test of β-lactam antibiotics in pediatrics.Frontiers in cellular and infection microbiology · 2023Review
- Improving antimicrobial stewardship with penicillin allergy testing: a review of current practices and unmet needs.JAC-antimicrobial resistance · 2022Review
- Drug allergy evaluation in children with suspected mild antibiotic allergy.Frontiers in allergy · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundPatients with a penicillin allergy label tend to have worse clinical outcomes and increased healthcare use. Drug provocation tests (DPT) are the gold-standard in the diagnostic workup of penicillin allergy, but safety concerns may hinder their performance. We aimed to assess the frequency of severe reactions following a DPT in patients with reported allergy to penicillins or other β-lactams.
methodsWe performed a systematic review, searching MEDLINE, Scopus, and Web of Science. We included primary studies assessing participants with a penicillin allergy label who underwent a DPT. We performed a Bayesian meta-analysis to estimate the pooled frequency of severe reactions to penicillin DPTs. Sources of heterogeneity were explored by subgroup and metaregression analyses.
resultsWe included 112 primary studies which included a total of 26,595 participants. The pooled frequency of severe reactions was estimated at 0.06% (95% credible interval [95% CrI] = 0.01%-0.13%; I
conclusionsIn patients with a penicillin allergy label, severe reactions resulting from DPTs are rare. Therefore, except for patients with potentially life-threatening index reactions or patients with positive skin tests-who were mostly not assessed in this analysis -, the safety of DPTs supports their performance in the diagnostic assessment of penicillin allergy.
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