ArticleThe journal of allergy and clinical immunology. In practice2021
Direct Challenges for the Evaluation of Beta-Lactam Allergy: Evidence and Conditions for Not Performing Skin Testing.
Article in The journal of allergy and clinical immunology. In practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06303128 (Penicillin Allergy Delabeling After a One-Dose Versus Two-Dose Graded Direct Oral Challenge), which is not on this map. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Penicillin Allergy Delabeling After a One-Dose Versus Two-Dose Graded Direct Oral Challenge
Who cites it
13 citing papers in PubMed, 36 citations in OpenAlex.
- Standards for practical management of drug hypersensitivity reactions to intravenous drugs and proactive early allergy involvement before referral: A WAO Statement.The World Allergy Organization journal · 2026Review
- Can Beta-Lactam Allergy De-Labeling Strategies Safely Empower Geriatric Care?Journal of clinical medicine · 2025Article
- Drug allergy.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2025Review
- How to manage drug-virus interplay underlying skin eruptions in children.The World Allergy Organization journal · 2024Review
- The state and consideration for skin test of β-lactam antibiotics in pediatrics.Frontiers in cellular and infection microbiology · 2023Review
- Approach for delabeling beta-lactam allergy in children.Frontiers in allergy · 2023Review
- Validation of the PEN-FAST Score in a Pediatric Population.JAMA network open · 2022Article
- The Impact of Reported β-Lactam Allergy on Clinical Outcomes and Antibiotic Use Among Solid Organ Transplant Recipients.Open forum infectious diseases · 2022Article
- Simplifying the drug provocation test in non-immediate hypersensitivity reactions to amoxicillin in children: The experience of a tertiary care allergy unit.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2022Article
- Safety, Outcomes, and Recommendations for Two-Step Outpatient Nonsteroidal Anti-Inflammatory Drug Challenges.The journal of allergy and clinical immunology. In practice · 2022Article
- Tools to improve the diagnosis and management of T-cell mediated adverse drug reactions.Frontiers in medicine · 2022Review
- Patients with questionable penicillin (beta-lactam) allergy: Causes and solutions.Allergologie select · 2022Review
- Direct oral provocation test with beta-lactams in Brazilian children and adolescents.Jornal de pediatriaArticle
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Authors and funding
6 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In the western world, up to 10% of the general population and more than 15% of hospitalized patients report penicillin allergy. After a comprehensive evaluation, more than 95% of patients who report a penicillin allergy can subsequently tolerate this antibiotic. Traditionally, the most widely accepted protocol to evaluate beta-lactam (BL) allergy consisted of skin testing (ST) followed by a drug provocation test (DPT) in ST-negative patients. DPT is the gold standard for proving or excluding BL allergy and is considered the final and definitive step in the evaluation. Recently, studies have been published that support the use of direct DPTs without preceding ST for both pediatric and adult patients who report a low-risk historical reaction to BLs. However, these studies use various risk-stratification criteria to determine eligibility for a direct DPT. A standardized protocol for DPT is also lacking. In this review, we assess the current literature and evidence for performing direct DPT in the pediatric and adult populations. On the basis of this evidence, we also present risk-based algorithms for the evaluation of BL allergy in pediatric and adult populations based on a description of the historical reaction.
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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.