Drug provocation testing: risk stratification is key
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Drug provocation testing : risk stratification is key. / Garvey, Lene H; Savic, Louise C.
I: Current Opinion in Allergy and Clinical Immunology, Bind 19, Nr. 4, 08.2019, s. 266-271.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Drug provocation testing
T2 - risk stratification is key
AU - Garvey, Lene H
AU - Savic, Louise C
PY - 2019/8
Y1 - 2019/8
N2 - PURPOSE OF REVIEW: This review aims to describe current best practice and recent advances in the use of risk stratification as a tool for drug provocation testing (DPT). In particular, we focus on the testing of unsubstantiated penicillin allergy labels.RECENT FINDINGS: The inherent risks of DPT are mitigated through careful selection of patients. A detailed history will elicit features of a potentially severe index reaction, as well as significant patient comorbidities which may increase the risks associated with DPT. Such patients require skin testing and/or in vitro testing prior to consideration for a DPT. However, there is increasing evidence that patients without these features may be able to proceed directly to DPT. This has been demonstrated extensively with unsubstantiated penicillin allergy labels, and a variety of risk stratification models have been employed to identify the 'low-risk' patient. Improved outcomes and reduced cost have been demonstrated with such models without compromising patient safety.SUMMARY: Risk stratification tools may enable well-tolerated and effective 'delabelling' of low-risk patients, with less demand on already scarce resources.
AB - PURPOSE OF REVIEW: This review aims to describe current best practice and recent advances in the use of risk stratification as a tool for drug provocation testing (DPT). In particular, we focus on the testing of unsubstantiated penicillin allergy labels.RECENT FINDINGS: The inherent risks of DPT are mitigated through careful selection of patients. A detailed history will elicit features of a potentially severe index reaction, as well as significant patient comorbidities which may increase the risks associated with DPT. Such patients require skin testing and/or in vitro testing prior to consideration for a DPT. However, there is increasing evidence that patients without these features may be able to proceed directly to DPT. This has been demonstrated extensively with unsubstantiated penicillin allergy labels, and a variety of risk stratification models have been employed to identify the 'low-risk' patient. Improved outcomes and reduced cost have been demonstrated with such models without compromising patient safety.SUMMARY: Risk stratification tools may enable well-tolerated and effective 'delabelling' of low-risk patients, with less demand on already scarce resources.
U2 - 10.1097/ACI.0000000000000543
DO - 10.1097/ACI.0000000000000543
M3 - Review
C2 - 31247633
VL - 19
SP - 266
EP - 271
JO - Current Opinion in Allergy and Clinical Immunology
JF - Current Opinion in Allergy and Clinical Immunology
SN - 1528-4050
IS - 4
ER -
ID: 233725046