Evidence map›Paper›PMID 34820050›Full record

ArticleThe World Allergy Organization journal2021

75% negative skin test results in patients with suspected hypersensitivity to beta-lactam antibiotics: Influencing factors and interpretation of test results.

Lukas Joerg, Susann Hasler, Anna Gschwend, Cordula Meincke, Thierry M Nordmann, Martin Glatz, Michelle Heilig, Benno Schnyder, Arthur Helbling, Peter Schmid-Grendelmeier

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The World Allergy Organization journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 19 citations in OpenAlex.

  1. Article
  2. Review
  3. [Penicillin allergy-Truth or duty?]Die Anaesthesiologie · 2024
    Review
  4. The state and consideration for skin test of β-lactam antibiotics in pediatrics.Frontiers in cellular and infection microbiology · 2023
    Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Lukas JoergAllergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
Susann HaslerAllergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
Anna GschwendDivision of Allergology and Clinical Immunology, Department of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Cordula MeinckeDivision of Allergology and Clinical Immunology, Department of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Thierry M NordmannAllergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
Martin GlatzAllergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
Michelle HeiligDivision of Allergology and Clinical Immunology, Department of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Benno SchnyderAllergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
Arthur HelblingDivision of Allergology and Clinical Immunology, Department of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Peter Schmid-GrendelmeierAllergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
University Hospital of Zurich · CHUniversity Hospital of Bern · CHUniversity of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe diagnostic approach for beta-lactam (BL) drug hypersensitivity reactions (DHR) is based on the history, clinical signs, skin tests (ST),

methodsIn this cross-sectional study the rate of positive ST in subjects with suspected DHR to penicillins and cephalosporins was investigated. Of special interest were correlations of ST positivity: 1) to the time intervals between index reaction and the allergic work-up, 2) time interval from drug exposure to the onset of signs, 3) pattern of manifestation in delayed DHR and involvement of test area in the index reaction, and 4) potential advantage of patch testing in delayed DHR.

results175 patients were included between January 2018 and April 2019 (63.4% female), 45 (25.7%) with immediate DHR manifestation and 130 with delayed DHR manifestation (74.3%). A total of 44 patients (25.1%) had a positive ST (immediate DHR 37.8% versus 20.0% in delayed DHR). ST positivity decreased in both groups after 3 years from 47.8% [95%CI 29.2-67] to 23.5% [95%CI 9.6-47.3] in immediate DHR and 23.0% [95%CI 15-4-32.9] to 12.9% [95%CI 5.1-28.9] in delayed DHR. The proportion of positive ST was higher in patients with more severe forms of delayed DHR, and in subjects with a shorter latency period of onset of symptoms after drug exposure: 0-3d: 29.5% [95%CI 19.6-41.9] vs. >3d: 11.6% [95%CI 6.0-21.2]). No sensitization was shown in delayed urticaria or angioedema. ST done outside the skin area involved during the index reaction were negative in all cases (0/38 vs. 26/84 in cases with involved area). The combination of patch test and intradermal test (IDT) revealed an additional positive result in 2/77 cases. Additional

conclusionIn most patients with negative test results, we could not clarify the cause of the BL-associated adverse events even with further investigations (including DPT). How to prevent new drug-induced adverse events in such patients has hardly been investigated yet. Corresponding cohort studies could improve the data situation.

Indexed as

AmoxicillinAnaphylaxisBasophil activation testBeta-lactamsCephalosporinsDrug allergyDrug hypersensitivityDrug provocation testIgEIntradermal skin testLymphocyte transformation testMaculopapular exanthemaPatch testPenicillinsSkin testT-cell

Identifiers

PMID34820050
PMCPMC8585645
OpenAlexW3213578936

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.