{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T08:57:28Z","timestamp":1780563448969,"version":"3.54.1"},"reference-count":49,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,10,25]],"date-time":"2020-10-25T00:00:00Z","timestamp":1603584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medizinische Universit\u00e4t Wien","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Allergology International"],"published-print":{"date-parts":[[2021,4]]},"DOI":"10.1016\/j.alit.2020.09.010","type":"journal-article","created":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T02:21:34Z","timestamp":1605234094000},"page":"244-251","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":10,"title":["Drug-specific history, skin and in\u00a0vitro tests can reduce the need for drug provocation tests in betalactam-hypersensitivity"],"prefix":"10.1016","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6324-0007","authenticated-orcid":false,"given":"Stefan","family":"W\u00f6hrl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Ostermayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Sesztak-Greinecker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhart","family":"Jarisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8613-0399","authenticated-orcid":false,"given":"Wolfgang","family":"Hemmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Wantke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.alit.2020.09.010_bib1","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1111\/all.13721","article-title":"A\u00a0EAACI drug allergy interest group survey on how European allergy specialists deal with beta-lactam allergy","volume":"74","author":"Torres","year":"2019","journal-title":"Allergy"},{"key":"10.1016\/j.alit.2020.09.010_bib2","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.jaip.2013.02.002","article-title":"Safely diagnosing clinically significant penicillin allergy using only penicilloyl-poly-lysine, penicillin, and oral amoxicillin","volume":"1","author":"Macy","year":"2013","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib3","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/all.12350","article-title":"International consensus on drug allergy","volume":"69","author":"Demoly","year":"2014","journal-title":"Allergy"},{"key":"10.1016\/j.alit.2020.09.010_bib4","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1159\/000453265","article-title":"Classification of drug hypersensitivity into allergic, p-i, and pseudo-allergic forms","volume":"171","author":"Pichler","year":"2016","journal-title":"Int Arch Allergy Immunol"},{"key":"10.1016\/j.alit.2020.09.010_bib5","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1001\/jama.2017.6510","article-title":"Penicillin allergy is not necessarily forever","volume":"318","author":"Trubiano","year":"2017","journal-title":"JAMA"},{"key":"10.1016\/j.alit.2020.09.010_bib6","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1111\/j.1468-3083.2010.03634.x","article-title":"Allergy is not the main trigger of urticaria in children referred to the emergency room","volume":"24","author":"Ricci","year":"2010","journal-title":"J\u00a0Eur Acad Dermatol Venereol"},{"key":"10.1016\/j.alit.2020.09.010_bib7","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1111\/pai.12565","article-title":"Non-immediate hypersensitivity reactions to beta-lactam antibiotics in children - our 10-year experience in allergy work-up","volume":"27","author":"Atanaskovi\u0107-Markovi\u0107","year":"2016","journal-title":"Pediatr Allergy Immunol"},{"key":"10.1016\/j.alit.2020.09.010_bib8","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.jaci.2013.09.021","article-title":"Health care use and serious infection prevalence associated with penicillin \"allergy\" in hospitalized patients: a cohort study","volume":"133","author":"Macy","year":"2014","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.alit.2020.09.010_bib9","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1001\/jama.2018.19283","article-title":"Evaluation and management of penicillin allergy: a review","volume":"321","author":"Shenoy","year":"2019","journal-title":"JAMA"},{"key":"10.1016\/j.alit.2020.09.010_bib10","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.jaip.2016.12.010","article-title":"Penicillin Allergy in Antibiotic Resistance Workgroup. Penicillin allergy testing should be performed routinely in patients with self-reported penicillin allergy","volume":"5","year":"2017","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib11","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s13601-017-0144-0","article-title":"Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America","volume":"7","author":"Torres","year":"2017","journal-title":"Clin Transl Allergy"},{"key":"10.1016\/j.alit.2020.09.010_bib12","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.jaip.2018.09.008","article-title":"Controversies in allergy: is skin testing required prior to drug challenges?","volume":"7","author":"Macy","year":"2019","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib13","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1111\/all.13951","article-title":"Diagnostic testing for penicillin allergy: a survey of practices and cost perceptions","volume":"75","author":"Sousa-Pinto","year":"2020","journal-title":"Allergy"},{"key":"10.1016\/j.alit.2020.09.010_bib14","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.3390\/ijms18061222","article-title":"The value of in\u00a0vitro tests to diminish drug challenges","volume":"18","author":"Mayorga","year":"2017","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.alit.2020.09.010_bib15","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1111\/all.12886","article-title":"In\u00a0vitro tests for drug hypersensitivity reactions: an ENDA\/EAACI Drug Allergy Interest Group position paper","volume":"71","author":"Mayorga","year":"2016","journal-title":"Allergy"},{"key":"10.1016\/j.alit.2020.09.010_bib16","doi-asserted-by":"crossref","first-page":"11","DOI":"10.5414\/ALX02104E","volume":"4","author":"Wurpts","year":"2020","journal-title":"Allergol Select"},{"key":"10.1016\/j.alit.2020.09.010_bib17","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s00508-011-0037-5","article-title":"Clinical practise guideline of the special interest group in allergy of the \u00d6GDV - drug provocation testing in the diagnosis of cutaneous drug reactions","volume":"123","author":"Kr\u00e4nke","year":"2011","journal-title":"Wien Klin Wochenschr"},{"key":"10.1016\/j.alit.2020.09.010_bib18","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s40413-016-0122-3","article-title":"Risk and safety requirements for diagnostic and therapeutic procedures in allergology: world Allergy Organization Statement","volume":"9","author":"Kowalski","year":"2016","journal-title":"World Allergy Organ J"},{"key":"10.1016\/j.alit.2020.09.010_bib19","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.jaip.2017.08.006","article-title":"The cost of penicillin allergy evaluation","volume":"6","author":"Blumenthal","year":"2018","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib20","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.jaip.2017.02.023","article-title":"Oral challenge without skin testing safely excludes clinically significant delayed-onset penicillin hypersensitivity","volume":"5","author":"Confino-Cohen","year":"2017","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib21","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.jaip.2017.01.023","article-title":"Amoxicillin challenge without penicillin skin testing in evaluation of penicillin allergy in a cohort of Marine recruits","volume":"5","author":"Tucker","year":"2017","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib22","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1016\/j.jaip.2019.05.037","article-title":"Comparing direct challenge to penicillin skin testing for the outpatient evaluation of penicillin allergy: a randomized controlled trial","volume":"7","author":"Mustafa","year":"2019","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib23","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s13223-020-00449-7","article-title":"Sensitivity and specificity of double-blinded penicillin skin testing in relation to oral provocation with amoxicillin in children","volume":"16","author":"Labrosse","year":"2020","journal-title":"Allergy Asthma Clin Immunol"},{"key":"10.1016\/j.alit.2020.09.010_bib24","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s40629-015-0052-6","volume":"24","author":"Brockow","year":"2015","journal-title":"Allergo J Int"},{"key":"10.1016\/j.alit.2020.09.010_bib25","doi-asserted-by":"crossref","first-page":"156","DOI":"10.3389\/fmed.2020.00156","article-title":"Intradermal tests with drugs: an approach to standardization","volume":"7","author":"Barbaud","year":"2020","journal-title":"Front Med (Lausanne)"},{"key":"10.1016\/j.alit.2020.09.010_bib26","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/1471-2334-9-61","article-title":"Ten years of antibiotic consumption in ambulatory care: trends in prescribing practice and antibiotic resistance in Austria","volume":"9","author":"Metz-Gercek","year":"2009","journal-title":"BMC Infect Dis"},{"key":"10.1016\/j.alit.2020.09.010_bib27","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s00508-009-1187-6","article-title":"The specificity of tests for anti-beta-lactam IgE antibodies declines progressively with increase of total serum IgE","volume":"121","author":"Zidarn","year":"2009","journal-title":"Wien Klin Wochenschr"},{"key":"10.1016\/j.alit.2020.09.010_bib28","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1111\/j.1398-9995.2012.02867.x","article-title":"Biological and genetic determinants of atopy are predictors of immediate-type allergy to betalactams, in Spain","volume":"67","author":"Cornejo-Garcia","year":"2012","journal-title":"Allergy"},{"key":"10.1016\/j.alit.2020.09.010_bib29","doi-asserted-by":"crossref","first-page":"e0121857","DOI":"10.1371\/journal.pone.0121857","article-title":"High serum \u03b2-lactams specific\/total IgE ratio is associated with immediate reactions to \u03b2-lactams antibiotics","volume":"10","author":"Vultaggio","year":"2015","journal-title":"PLoS One"},{"issue":"Part B","key":"10.1016\/j.alit.2020.09.010_bib30","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1016\/j.bbadis.2017.08.033","article-title":"Drug-induced bile duct injury","volume":"1864","author":"Visentin","year":"2018","journal-title":"Biochim Biophys Acta Mol Basis Dis"},{"key":"10.1016\/j.alit.2020.09.010_bib31","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1111\/all.12929","article-title":"Drug allergy passport and other documentation for patients with drug hypersensitivity - an ENDA\/EAACI Drug Allergy Interest Group Position Paper","volume":"71","author":"Brockow","year":"2016","journal-title":"Allergy"},{"key":"10.1016\/j.alit.2020.09.010_bib32","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.aller.2014.05.002","article-title":"Clinical characteristics and risk profile of patients with elevated baseline serum tryptase","volume":"42","author":"Fellinger","year":"2014","journal-title":"Allergol Immunopathol (Madr)"},{"key":"10.1016\/j.alit.2020.09.010_bib33","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1111\/j.1398-9995.2006.01148.x","article-title":"Patients with drug reactions - is it worth testing?","volume":"61","author":"W\u00f6hrl","year":"2006","journal-title":"Allergy"},{"key":"10.1016\/j.alit.2020.09.010_bib34","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.jaci.2018.09.022","article-title":"Controversies in drug allergy: in\u00a0vitro testing","volume":"143","author":"Mayorga","year":"2019","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.alit.2020.09.010_bib35","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1016\/j.jaip.2017.08.009","article-title":"Use of the basophil activation test may reduce the need for drug provocation in amoxicillin-clavulanic allergy","volume":"6","author":"Salas","year":"2018","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib36","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1111\/pai.13041","article-title":"Skin tests are important in children with beta-lactam hypersensitivity, but may be reduced in number","volume":"30","author":"Diaferio","year":"2019","journal-title":"Pediatr Allergy Immunol"},{"key":"10.1016\/j.alit.2020.09.010_bib37","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.jaip.2017.03.014","article-title":"Positive skin test or specific IgE to penicillin does not reliably predict penicillin allergy","volume":"5","author":"Tannert","year":"2017","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib38","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1111\/jdv.15986","article-title":"Cross-reactivity in beta-lactams after a non-immediate cutaneous adverse reaction: experience of a reference centre for toxic bullous diseases and severe cutaneous adverse reactions","volume":"34","author":"B\u00e9rot","year":"2020","journal-title":"J\u00a0Eur Acad Dermatol Venereol"},{"key":"10.1016\/j.alit.2020.09.010_bib39","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1159\/000495302","article-title":"The diagnosis of ceftriaxone hypersensitivity in a paediatric population","volume":"178","author":"Mori","year":"2019","journal-title":"Int Arch Allergy Immunol"},{"key":"10.1016\/j.alit.2020.09.010_bib40","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1542\/peds.2007-3178","article-title":"Diagnosing hypersensitivity reactions to cephalosporins in children","volume":"122","author":"Romano","year":"2008","journal-title":"Pediatrics"},{"key":"10.1016\/j.alit.2020.09.010_bib41","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.7326\/0003-4819-140-12-200406150-00009","article-title":"Drug provocation tests in patients with a history suggesting an immediate drug hypersensitivity reaction","volume":"140","author":"Messaad","year":"2004","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.alit.2020.09.010_bib42","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s40629-018-0064-0","article-title":"NSAID hypersensitivity \u2013 recommendations for diagnostic work up and patient management","volume":"27","author":"W\u00f6hrl","year":"2018","journal-title":"Allergo J Int"},{"key":"10.1016\/j.alit.2020.09.010_bib43","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.jaip.2016.09.041","article-title":"Identifying allergic drug reactions through placebo-controlled graded challenges","volume":"5","author":"Iammatteo","year":"2017","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib44","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/j.1398-9995.2009.02228.x","article-title":"Determining the negative predictive value of provocation tests with beta-lactams","volume":"65","author":"Demoly","year":"2010","journal-title":"Allergy"},{"key":"10.1016\/j.alit.2020.09.010_bib45","year":"2000"},{"key":"10.1016\/j.alit.2020.09.010_bib46","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1016\/j.jaip.2018.11.023","article-title":"Drug hypersensitivity reactions documented in electronic health records within a large health system","volume":"7","author":"Wong","year":"2019","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.alit.2020.09.010_bib47","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1002\/pds.2076","article-title":"Self-reported prevalence of hypersensitivity reactions against drugs among medical students: does awareness cause any difference?","volume":"20","author":"Bavbek","year":"2011","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"10.1016\/j.alit.2020.09.010_bib48","doi-asserted-by":"crossref","first-page":"2111","DOI":"10.1111\/all.14292","article-title":"Prevalence of self-reported and confirmed penicillin allergy in a Belgian outpatient population","volume":"75","author":"Van Gasse","year":"2020","journal-title":"Allergy"},{"key":"10.1016\/j.alit.2020.09.010_bib49","first-page":"57","article-title":"Prevalence of allergen sensitization among 15,534 patients with suspected allergic diseases in Henan Province, China","volume":"37","author":"Sun","year":"2019","journal-title":"Asian Pac J Allergy Immunol"}],"container-title":["Allergology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1323893020301374?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1323893020301374?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T18:10:53Z","timestamp":1761156653000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1323893020301374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":49,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["S1323893020301374"],"URL":"https:\/\/doi.org\/10.1016\/j.alit.2020.09.010","relation":{},"ISSN":["1323-8930"],"issn-type":[{"value":"1323-8930","type":"print"}],"subject":[],"published":{"date-parts":[[2021,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Drug-specific history, skin and in\u00a0vitro tests can reduce the need for drug provocation tests in betalactam-hypersensitivity","name":"articletitle","label":"Article Title"},{"value":"Allergology International","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.alit.2020.09.010","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Japanese Society of Allergology. Production and hosting by Elsevier B.V.","name":"copyright","label":"Copyright"}]}}