In brief

June 2016   Comments

Amoxicillin allergy testing goes more than skin deep

Amoxicillin is one of the most commonly prescribed antibiotics in children. Skin tests traditionally used to predict allergies to the antibiotic have a high false-negative rate, according to researchers at the McGill University Health Centre. In a study published in JAMA Pediatrics, the researchers determined that an oral provocation, or challenge, test (PC), with appropriate followup, was a more efficient and safer screening method for diagnosing non-life-threatening reactions to amoxicillin in children.

To assess the use of a graded PC, the researchers assessed children at the Montreal Children’s Hospital allergy clinic who presented with a rash that was suspected to be caused by an amoxicillin allergy. Of 818 children assessed in the three-year study, 770 did not have a reaction to the graded PC for amoxicillin. Seventeen had an immediate allergic reaction, and only one within this group had a positive skin test. Thirty-one of the children had mild reactions that developed more than one hour after challenge.

Up to 10 per cent of children develop rashes while on antibiotics. Most subsequently avoid the suspect antibiotic in favour of alternatives that may be less effective, more toxic and more expensive.

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