{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T13:09:53Z","timestamp":1775135393210,"version":"3.50.1"},"reference-count":27,"publisher":"Oceanside Publications Inc.","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold>The first-line method in the diagnosis of patients who describe an immediate reaction after penicillin intake is a skin test (ST) with penicillin reagents.<jats:bold>Objectives:<\/jats:bold>We aimed to determine the safety and diagnostic value of penicillin STs in the diagnosis of immediate reactions to penicillins in pediatric patients.<jats:bold>Methods:<\/jats:bold>The study included pediatric patients with suspected immediate reaction to penicillin who were subjected to STs by using a standard penicillin test kit as well as suspected penicillin and the drug provocation tests (DPT) with the suspected penicillin at our clinic.<jats:bold>Results:<\/jats:bold>A total of 191 patients (53.9% boys) with a median age of 6.83 years (interquartile range, 4.2\u201012 years) were included in the study. The time from drug intake to the onset of reaction was \u22641 hour in 138 patients (72.3%) and 1 to 6 hours in 53 patients (27.7%). Penicillin allergy (PA) was confirmed by diagnostic tests in 36 of the 191 patients (18.8%). In multivariate logistic regression analysis, the history of both urticaria and angioedema (odds ratio [OR] 27.683 [95% confidence interval {CI}, 3.143\u2010243.837]; p\u2009=\u20090.003) and anaphylaxis (OR 56.246 [95% CI, 6.598\u2010479.489]; p\u2009&lt;\u20090.001) were the main predictors of a PA diagnosis. Although ST results were positive in 23 patients (63.8%), 13 patients (26.2%) had positive DPT results despite negative ST results. The negative predictive value (NPV) of STs was calculated 92.2% (155\/168). None of our patients experienced immediate or delayed systemic and\/or local reactions in relation to the STs.<jats:bold>Conclusion:<\/jats:bold>A history of urticaria with angioedema and anaphylaxis were the main predictors of true PA in children with suspected immediate reactions. STs with penicillin reagents are safe for use in children. Although STs have a high NPV, DPT is the gold standard for diagnosis. DPTs should be performed as the final step of the diagnostic evaluation of PA in patients with negative ST results.<\/jats:p>","DOI":"10.2500\/aap.2020.41.200082","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T05:00:37Z","timestamp":1603861237000},"page":"442-448","source":"Crossref","is-referenced-by-count":8,"title":["Diagnostic value and safety of penicillin skin tests in children with immediate penicillin allergy"],"prefix":"10.2500","volume":"41","author":[{"given":"Ilknur","family":"Kulhas Celik","sequence":"first","affiliation":[{"name":"From the Division of Pediatric Allergy and Immunology, Ankara City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irem","family":"Turgay Yagmur","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Allergy and Immunology, Ankara City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ozge","family":"Yilmaz Topal","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Allergy and Immunology, Ankara City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muge","family":"Toyran","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Health Sciences University, Ankara City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ersoy","family":"Civelek","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Health Sciences University, Ankara City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Betul","family":"Karaatmaca","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Allergy and Immunology, Ankara City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emine","family":"Dibek Misirlioglu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Health Sciences University, Ankara City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1355","reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/all.12774","article-title":"Drug hypersensitivity in children: report from the pediatric task force of the EAACI Drug Allergy Interest Group","volume":"71","author":"Gomes","year":"2016","journal-title":"Allergy"},{"key":"B2","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1111\/cea.12468","article-title":"Management of allergy to penicillins and other beta-lactams","volume":"45","author":"Mirakian","year":"2015","journal-title":"Clin Exp Allergy"},{"key":"B3","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1111\/pai.12155","article-title":"Diagnostic evaluation of hypersensitivity reactions to beta-lactam antibiotics in a large population of children","volume":"25","author":"Zambonino","year":"2014","journal-title":"Pediatr Allergy Immunol"},{"key":"B4","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/pai.12047","article-title":"Prevalence of confirmed immediate type drug hypersensitivity reactions among school children","volume":"24","author":"Erko\u00e7o\u011flu","year":"2013","journal-title":"Pediatr Allergy Immunol"},{"key":"B5","doi-asserted-by":"crossref","first-page":"82","DOI":"10.2500\/aap.2020.41.190024","article-title":"Proactive management of penicillin and other antibiotic allergies","volume":"41","author":"Khan","year":"2020","journal-title":"Allergy Asthma Proc"},{"key":"B6","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1136\/jclinpath-2014-202438","article-title":"A real-time prospective evaluation of clinical pharmaco-economic impact of diagnostic label of \u2018penicillin allergy\u2019 in a UK teaching hospital","volume":"67","author":"Li","year":"2014","journal-title":"J Clin Pathol"},{"key":"B7","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1002\/pds.2134","article-title":"Clinical characteristics of patients with drug hypersensitivity in Norway: a single-centre study","volume":"20","author":"Chalabianloo","year":"2011","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"B8","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 \u201callergy\u201d in hospitalized patients: a cohort study","volume":"133","author":"Macy","year":"2014","journal-title":"J Allergy Clin Immunol"},{"key":"B9","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1111\/all.14122","article-title":"Towards a more precise diagnosis of hypersensitivity to beta-lactams - 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