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The aim was to evaluate the usefulness of in vivo tests and basophil activation test (BAT) for the diagnosis of IHRs due to metronidazole and ornidazole and to determine possible cross\u2010reactivity in between.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010nine patients with a clear history of IHRs due to these drugs and 20 healthy subjects who were known to tolerate these drugs were included. Skin tests (STs) and single\u2010blind placebo\u2010controlled drug provocation tests (SBPCDPTs) were performed with both drugs whereas BAT was applied only with the culprit drug.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most and least common reaction types were urticaria\/angioedema (34.7%) and anaphylaxis (14.3%), respectively. SBPCDPTs were positive in 15 out of 47 patients, and only 7 had positive STs. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of STs for metronidazole\/ornidazole were 33.3%\/16.6%, 94.2%\/97.3%, 60%\/50%, and 84.6%\/88.1%, respectively. BAT was positive in 12 out of 15 patients and negative in 10 control subjects, giving a sensitivity rate of 71.4% (CI, 29.0%\u201096.3%) for metronidazole and 83.3% (CI, 35.8%\u201099.5%) for ornidazole. The optimal concentration of both drugs for BAT was determined as 5\u00a0mg\/mL. No cross\u2010reactivity among two drugs was observed according to in vivo tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study showed that SBPCDPT and BAT are both useful diagnostic tools for IHRs due to 5\u2010nitroimidazole antibiotics and can be used as supplementary to each other. No cross\u2010reactivity between metronidazole and ornidazole in IHRs exists.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.14542","type":"journal-article","created":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T03:30:27Z","timestamp":1596684627000},"page":"842-852","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Diagnostic workup including CD203c\u2010based basophil activation test in immediate hypersensitivity due to metronidazole and ornidazole and evaluation of cross\u2010reactivity in between"],"prefix":"10.1111","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1505-4293","authenticated-orcid":false,"given":"\u015eeng\u00fcl","family":"Beyaz","sequence":"first","affiliation":[{"name":"Division of Immunology and Allergic Diseases Department of Internal Medicine Istanbul Faculty of Medicine Istanbul University Istanbul 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