{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:00:00Z","timestamp":1791547200066,"version":"4.3.4"},"reference-count":70,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009473","name":"Universidad de M\u00e1laga","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009473","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Penicillins (PENs) are the most frequent drug\u2010allergic reactions trigger. However, diagnostic work\u2010up is complex and time\u2010consuming: it requires skin testing (ST) and drug\u2010provocation test (DPT), needing faster delabelling strategies. Although direct DPT without previous STs has shown to be safe, most of the studies are performed in children or in North American, Asian, or Oceanian adults, with few studies in the European adult population. We explored its safety in European adult patients with low\u2010risk PEN allergy history and, additionally, analysed ST role and T\u2010cell involvement by lymphocyte transformation test (LTT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively evaluated &gt;\u200916\u2009years of PEN\u2010allergic labelled patients referred to M\u00e1laga Regional University Hospital during 2023. They reported non\u2010immediate reactions without alarm signs and unknown reactions. Direct\u2010single\u2010dose DPT was performed in all patients. If positive, ST and LTT were carried out after reaction resolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 269 patients with the culprits being an unidentified PEN (36%), amoxicillin (AX) (32%), and AX\u2010clavulanic acid (AX\u2010CLV) (31%); and the symptoms maculopapular exanthema (MPE) (34%) and unknown reaction during childhood (23%). Only 16 (5.9%) had positive DPT, being 56% for AX and 44% for AX\u2010CLV, 81% developing MPE, none severe. Most DPT\u2010reacting patients reported cutaneous non\u2010immediate reactions in the index reaction, and only one had an unknown childhood reaction. The mean day interval between drug administration and symptom development was lower (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) in positive DPT than in the index reaction (2 vs 5\u2009days). Moreover, ST was positive in only 19% and LTTs in 86.7% of positive DPT patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Direct\u2010single\u2010dose DPT is safe for delabelling PEN allergy in non\u2010immediate reactions without alarm signs and unknown reactions. ST had a poor diagnostic value and LTT had a high one, confirming a T\u2010cell involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.16567","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T08:20:02Z","timestamp":1747383602000},"page":"3127-3139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Direct Single\u2010Dose Drug\u2010Provocation Test Is Safe for Delabelling Penicillin Low\u2010Risk Reactions in Adults"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9618-4067","authenticated-orcid":false,"given":"Marina","family":"Labella","sequence":"first","affiliation":[{"name":"Allergy Unit Hospital Regional Universitario de M\u00e1laga  M\u00e1laga Spain"},{"name":"Allergy Research Group Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina\u2010IBIMA Plataforma BIONAND  M\u00e1laga 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