{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T21:45:10Z","timestamp":1776721510241,"version":"3.51.2"},"reference-count":22,"publisher":"Colegio Mexicano de Inmunologia Clinica y Alergia, A. C.","issue":"1","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Alerg Mex"],"abstract":"<jats:p>OBJETIVO: Evaluar el desaf\u00edo simple ciego placebo controlado a penicilina en pacientes con VIH-SIDA sin prueba cut\u00e1nea previa.\nM\u00c9TODOS: Estudio prospectivo, llevado a cabo en pacientes que acudieron al Centro Ambulatorio para la Prevenci\u00f3n y Atenci\u00f3n en SIDA e Infecciones de Transmisi\u00f3n Sexual de Puebla, M\u00e9xico. Para el an\u00e1lisis estad\u00edstico se calcularon porcentajes, frecuencias, promedios, desviaci\u00f3n est\u00e1ndar y medianas; \u00a0c2 o exacta de Fisher, Kruskal-Wallis unidireccional, V Cramer; distribuci\u00f3n binomial. Para el an\u00e1lisis de los datos se utiliz\u00f3 el programa Statistical Package, for the Social Sciencies 26.\nRESULTADOS: Se registraron 104 pacientes iguales o mayores de 18 a\u00f1os (media de edad de 34.6 \u00b1 10.5 a\u00f1os): mujeres (n = 3; 2.9%), hombres (n = 101; 97.1%). En cuanto a las variables de estudio se encontr\u00f3: 7 (6.7%) desaf\u00edos positivos a penicilina, 2 (1.9%) a placebo y 95 (91.3%) sin reacci\u00f3n; tama\u00f1o del efecto V = 0.038, p = 0.701 (placebo-penicilina), V = 1, p = 0.000 (sin reacci\u00f3n-reacci\u00f3n penicilina) distribuci\u00f3n binomial y B (7; 0.1533). Respecto de las comorbilidades se observ\u00f3 diferencia entre los grupos (p&lt;0.05) en s\u00edntomas durante el desaf\u00edo: prurito en el grupo de reacci\u00f3n a penicilina (p = 0.03) y ansiedad en el grupo placebo (p = 0.005).\nCONCLUSIONES: En pacientes con VIH-SIDA categorizados de bajo riesgo, el desaf\u00edo farmacol\u00f3gico a penicilina simple ciego con placebo permiti\u00f3 desetiquetar la posible alergia, porque el beneficio del antibi\u00f3tico es decisivo para la evoluci\u00f3n satisfactoria de la enfermedad.\nPALABRAS CLAVE: VIH-SIDA; Penicilina; Prurito, Ansiedad; Alergia; Antibi\u00f3ticos.\n\u00a0<\/jats:p>","DOI":"10.29262\/ram.v73i1.1546","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T02:34:43Z","timestamp":1774924483000},"page":"9-16","source":"Crossref","is-referenced-by-count":0,"title":["&lt;b&gt;Prueba de desaf\u00edo por v\u00eda oral con placebo controlado a penicilina en pacientes de bajo riesgo con VIH sin prueba cut\u00e1nea previa&lt;\/b&gt;","&lt;b&gt;Placebo-controlled graded oral penicillin challenge in low-risk patients living with HIV without prior skin testing&lt;\/b&gt;"],"prefix":"10.29262","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5779-138X","authenticated-orcid":false,"given":"Mar\u00eda del Roc\u00edo","family":"Hern\u00e1ndez Morales","sequence":"first","affiliation":[{"name":"Hospital General \u201cDr. Eduardo V\u00e1zquez N.\u201d, Puebla, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2613-4878","authenticated-orcid":false,"given":"Christian","family":"Hern\u00e1ndez Le\u00f3n","sequence":"additional","affiliation":[{"name":"UNEME CAPASITS Puebla, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9870-8039","authenticated-orcid":false,"given":"Eleazar","family":"Mancilla Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"UNEME CAPASITS Puebla, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8238-1297","authenticated-orcid":false,"given":"Elizabeth","family":"Papaqui Lim\u00f3n","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en el \u00c1rea de la Salud, Puebla, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7913-5945","authenticated-orcid":false,"given":"Estefan\u00eda","family":"Alavez L\u00f3pez","sequence":"additional","affiliation":[{"name":"Hospital General \u201cDr. Eduardo V\u00e1zquez N.\u201d, Puebla, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0885-4867","authenticated-orcid":false,"given":"Ana Karen","family":"Castellanos Guerrero","sequence":"additional","affiliation":[{"name":"Hospital General \u201cDr. Eduardo V\u00e1zquez N.\u201d, Puebla, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8308-9926","authenticated-orcid":false,"given":"Itzel Victoria","family":"Rojas Guzm\u00e1n","sequence":"additional","affiliation":[{"name":"Hospital General \u201cDr. Eduardo V\u00e1zquez N.\u201d, Puebla, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7505-8567","authenticated-orcid":false,"given":"Pedro","family":"Crist\u00f3bal Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Hospital General \u201cDr. Eduardo V\u00e1zquez N.\u201d, Puebla, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"11808","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"66771","doi-asserted-by":"crossref","unstructured":"1. Phillips E, Mallal S. Drug hypersensitivity in HIV. Curr Opin Allergy Clin Immunol. 2007; 7 (4): 324-30. doi: 10.1097\/ACI.0b013e32825ea68a.","DOI":"10.1097\/ACI.0b013e32825ea68a"},{"key":"66772","doi-asserted-by":"crossref","unstructured":"2. Peter J, Choshi P, Lehloenya RJ. Drug hypersensitivity in HIV infection. Curr Opin Allergy Clin Immunol. 2019; 19 (4): 272-282. doi: 10.1097\/ACI.0000000000000545.","DOI":"10.1097\/ACI.0000000000000545"},{"key":"66773","doi-asserted-by":"crossref","unstructured":"3. Trubiano JA, Vogrin S, Chua KYL, Bourke J, et al. Development and Validation of a Penicillin Allergy Clinical Decision Rule. JAMA Intern Med. 2020; 180 (5): 745-752. doi: 10.1001\/jamainternmed.2020.0403.","DOI":"10.1001\/jamainternmed.2020.0403"},{"key":"66774","doi-asserted-by":"crossref","unstructured":"4. Jeimy S, Wong T, Ben-Shoshan M, Copaescu AM, et al. Drug allergy. Allergy Asthma Clin Immunol. 2025; 20 (Suppl 3): 78. doi: 10.1186\/s13223-024-00936-1. 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Direct Challenges for the Evaluation of Beta-Lactam Allergy: Evidence and Conditions for Not Performing Skin Testing. J Allergy Clin Immunol Pract. 2021; 9 (8): 2947-2956. doi: 10.1016\/j.jaip.2021.04.073.","DOI":"10.1016\/j.jaip.2021.04.073"},{"key":"66778","doi-asserted-by":"crossref","unstructured":"8. Ramsey A, Rozario C, Stern J. Direct challenges are the gold standard for most antibiotic allergy evaluations. Ann Allergy Asthma Immunol. 2023; 131 (4): 427-433. doi: 10.1016\/j.anai.2023.03.033.","DOI":"10.1016\/j.anai.2023.03.033"},{"key":"66779","doi-asserted-by":"crossref","unstructured":"9. Castells M, Khan DA, Phillips EJ. Penicillin Allergy. N Engl J Med. 2019; 381 (24): 2338-2351. doi: 10.1056\/NEJMra1807761.","DOI":"10.1056\/NEJMra1807761"},{"key":"66780","doi-asserted-by":"crossref","unstructured":"10. Banks TA, Tucker M, Macy E. Evaluating Penicillin Allergies Without Skin Testing. 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