scholarly journals Evaluation of immediate reactions to β lactam antibiotics using a comprehensive diagnostic protocol

2017 ◽  
Vol 6 (10) ◽  
pp. 2366
Author(s):  
Bhanuja Bhagwat ◽  
Anuradha H. V.
Keyword(s):  
Skin Prick Test ◽  
Drug Hypersensitivity ◽  
Tertiary Care ◽  
Provocation Test ◽  
Intradermal Test ◽  
Care Hospital ◽  
Prick Test ◽  
Diagnostic Protocol ◽  
Drug Provocation Test ◽  
Immediate Reactions

Background: β lactam antibiotics are commonly prescribed groups of antibacterial drugs for various infections however the prevalence of its allergic effects is not clear in our country, hence the need for an effective diagnostic protocol to determine immediate hypersensitivity reactions. The objective was to formulate a diagnostic protocol for evaluating immediate drug hypersensitivity to β lactam antibiotics.Methods: A prospective study was conducted at a tertiary care hospital. Adults who were prescribed any class of β lactam antibiotic were included. Non irritating concentrations of the antibiotic as per The European Network on drug Allergy were used. A strict three step diagnostic algorithm with skin prick test followed by intradermal test and drug provocation test, with 20 minutes observation period between each step, to determine cutaneous allergic reactions was followed.Results: The most commonly prescribed drug was cefazolin, followed by ceftriaxone, and cefoperazone + sulbactam combination. The culprit drugs were ceftriaxone in 4 (4.7%) patients, followed by piperacillin + tazobactam combination in 3 (3.5%), amoxicillin + clavulanic acid in 2 (2.3%) and 1 (1.1%) each for cefotaxime and cefepime + tazobactam combination. No patients were positive for skin prick test; 2.4% were positive for intradermal test and 10.6% were positive for drug provocation test.Conclusions: This diagnostic protocol is apt to adequately diagnose immediate reactions to β lactam antibiotics and henceforth can be used effectively in India. However, the skin prick test may be excluded but the intradermal test and drug provocation test is crucial to identify these immediate reactions.

scholarly journals Prevalence of Aeroallergens in Allergic Rhinitis in a Tertiary Care Hospital

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Monika Pokharel ◽  
Bikash Lal Shrestha ◽  
Dharmendra Karn ◽  
Ashish Dhakal ◽  
Abha Kiran K.C. ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Data Entry ◽  
Sampling Technique ◽  
House Dust Mites ◽  
Care Hospital ◽  
Cross Sectional ◽  
Prick Test

Introduction: The prevalence of allergic rhinitis has increased significantly globally over the last two decades. Detection of sensitizing aeroallergens plays a crucial role in the diagnosis and management of this troublesome disease. This study aims to investigate the spectrum of aeroallergens sensitization in patients with allergic rhinitis in a tertiary care hospital. Methods: A descriptive cross-sectional study conducted in the Department of Otorhinolaryngology of our hospital between January 2016 to December 2019. Ethical approval was taken from the Institutional Review Committee (No: 210/19). Patients diagnosed with allergic rhinitis were enrolled using the convenience sampling technique. Data entry and analysis was done using IBM Statistical Package for Social Sciences version 20.0. Results: Among 170 patients, altogether 103 (60.6%) patients yielded positive responses on the skin prick test. The most prevalent aeroallergens were Lepidoglyphus 86 (50.60%), Dermatophagoides pteronyssinus 85 (50%), Dermatophagoides farina 82 (48.20%), Thyrophagus 50 (29.40%), Blomia 46 (27.10%), Acarus 43 (25.30%), cat dander 26 (15.30%), dog dander 24 (14.10%), cow and buffalo dander 20 (11.8%), ragweed 20 (11.8%), grass pollen 18 (10.60%) and mugwort 17 (10%). Conclusions: This study highlights that the frequency of aeroallergens based on skin prick test in patients presenting to a tertiary care hospital which showed the dominance of house dust mites, dog and cat hair, pollen, and grasses. Reduced exposure and training of patients about protection against these agents will possibly help in controlling the severity of allergic rhinitis in this region.

scholarly journals Immunotherapy – 2066. A study on skin prick test patterns of atopic patients managed in a tertiary care setting of Sri Lanka

2013 ◽  
Vol 6 ◽  
pp. P149
Author(s):  
Anoma Siribaddana ◽  
Fariha Sitheeque ◽  
Sonali Surangi ◽  
Srinath Illeperuma ◽  
Dinesh Dassanayaka
Keyword(s):  
Sri Lanka ◽  
Skin Prick Test ◽  
Care Setting ◽  
Tertiary Care ◽  
Prick Test ◽  
Tertiary Care Setting

scholarly journals DRUG PROVOCATION TEST AS A DIAGNOSTIC APPROACH FOR HYPERSENSITIVITY REACTION TO ANTITUBERCULOSIS DRUGS: A REPORT OF TWO CASES

2020 ◽  
pp. 1-4 ◽  
Author(s):  
KETUT SURYANA
Keyword(s):  
Therapeutic Approach ◽  
Patient Adherence ◽  
Drug Hypersensitivity ◽  
Public Health Problem ◽  
Provocation Test ◽  
Hypersensitivity Reactions ◽  
Increased Risk ◽  
Drug Provocation Test ◽  
Drug Hypersensitivity Reactions ◽  
Degrees Of Severity

Pulmonary tuberculosis (PTB) continues to be a public health problem, especially in developing countries. The necessity use of multidrug regimens of antituberculosis drug (ATD) in PTB treatment has been associated with increased risk of drug hypersensitivity reactions (DHRs). DHR is a type of unpredictable reaction, refers to immunologically mediated hypersensitivity reactions. It is observed more frequently in the intensive phase of the PTB treatment with varying degrees of severity. DHR can lead to reduce the patient adherence, thereby leading to stoppage of the drugs by the patient. The definite diagnosis based on drug provocation test (DPT) that should be performed at a hospital. The recommended therapeutic approach is rapid desensitization by reintroducing drugs in safety and optimal under threshold dose until usual daily dose is reached. We present two cases of DHR to ATD, DPT as the diagnosis and rapid desensitization as the therapeutic approach.

Skin Prick Test Versus Phadiatop as a Tool for Diagnosis of Allergic Rhinitis in Children

2020 ◽  
Vol 35 (1) ◽  
pp. 98-106
Author(s):  
Sasiwimon Traiyan ◽  
Wiparat Manuyakorn ◽  
Watcharoot Kanchongkittiphon ◽  
Cherapat Sasisakulporn ◽  
Wanlapa Jotikasthira ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Provocation Test ◽  
Specific Ige ◽  
Prick Test ◽  
The Past ◽  
Negative Results ◽  
Dust Mite ◽  
The Mean ◽  
Positive Results

Background Skin prick test (SPT) or Phadiatop, a multi-allergen IgE screening test, was used as a tool for detecting aeroallergen sensitization. Objective To compare SPT and Phadiatop as a tool for diagnosis allergic rhinitis (AR) using the nasal provocation test (NPT) as a comparative standard. Methods Children aged 5-18 years with rhinitis symptoms more than 6 times in the past year were enrolled. SPT to 13 common aeroallergens, serum for Phadiatop, and NPT to Dermatophagoides pteronyssinus (Der p) were performed. NPT to mixed cockroach (CR) were performed in children who had CR sensitization and negative NPT to Der p. Children who had a disagreement between the result of SPT and Phadiatop or having negative results were evaluated for specific IgE (sIgE) to common aeroallergens. Results One hundred-forty children were enrolled with the mean age of 9.8 ± 3 years, 56% were male. Of 92 children (65.7%) with positive SPT to any aeroallergens, 88 children (95.6%) were sensitized to house dust mite (HDM). NPT showed positive results in 97 children (69.3%). Of 48 children who showed negative SPT, 4 children (8.3%) had sIgE to aeroallergens but NPT was positive in 1 child. Eighty-eight children (62.9%) had positive tests for Phadiatop and 4 (4.5%) of them had negative results for NPT to Der p. Among 52 children who had negative results for Phadiatop, 4 children (7.6%) had sIgE to aeroallergens but NPT was positive in 2 children (3.8%). SPT and Phadiatop showed 94.2% agreement: with Kappa 0.876, p < 0.001. Using NPT as a comparative standard for diagnosis for AR, SPT showed a sensitivity of 89.6% and specificity of 88.3% and Phadiatop provided the sensitivity of 88.6% and specificity of 95.3%. Conclusions SPT to aeroallergen and Phadiatop have good and comparable sensitivity and specificity for the diagnosis of AR in children.

Single dose prolonged drug provocation test, without previous skin testing, is safe for diagnosing children with mild non‐immediate reactions to betalactams

Allergy ◽  
2021 ◽  
Author(s):  
Ana Prieto ◽  
Candelaria Muñoz ◽  
Gádor Bogas ◽  
Rubén Fernández‐Santamaría ◽  
Francisca Palomares ◽  
...  
Keyword(s):  
Single Dose ◽  
Skin Testing ◽  
Provocation Test ◽  
Drug Provocation Test ◽  
Immediate Reactions

scholarly journals A Descriptive Study on Aeroallergen Sensitivity Pattern in Children with Bronchial Asthma and/or Allergic Rhinitis

2020 ◽  
Vol 10 (01) ◽  
pp. e48-e52
Author(s):  
Saket Yadav ◽  
Madhu Mathur ◽  
Gunjan Agarwal ◽  
Abhishek Kumar Sharma
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Bronchial Asthma ◽  
Skin Prick Testing ◽  
Tertiary Care ◽  
Kentucky Bluegrass ◽  
Health Concern ◽  
Prick Test ◽  
Airway Diseases ◽  
Sensitivity Pattern

Abstract Background The growing prevalence of allergy and asthma in India has become a major health concern, with symptoms ranging from mild rhinitis to severe asthma, and aeroallergens play a major role in the pathogenesis of reactive airway diseases. The distribution of aeroallergen and the knowledge of allergen sensitivity pattern in northern India (Rajasthan) are limited. The aim of our study was to determine the prevalence of various aeroallergens in children with bronchial asthma and/or allergic rhinitis by skin prick test at a tertiary care center in Jaipur, Rajasthan, India. Methods Children who had presented to the Department of Pediatrics (outpatient department and inpatient department), Mahatma Gandhi Medical College, Jaipur, from January 2018 to June 2019 fulfilling the inclusion criteria, were included in this prospective study. A total of 15 antigens were used. Skin prick testing was performed as per standard protocol. Result Among total 60 children with respiratory allergic diseases, overall the highest percentage of skin prick test positivity was found among house dust mite (66.6%), storage mite (41.6%), wheat (33.3%), animal dander (30%), and Kentucky bluegrass (26.6%), in that order. Conclusion It is advised to avoid common inhaled allergens found with SPT in our region in children with allergic airway diseases.

scholarly journals Seasonal variation of allergy profile of patients visiting a tertiary care hospital in hilly areas of Himachal Pradesh

2018 ◽  
Vol 6 (1) ◽  
pp. 146
Author(s):  
Manpreet S. Nanda ◽  
Rama Devi
Keyword(s):  
Seasonal Variation ◽  
Tertiary Care ◽  
Allergic Diseases ◽  
Nasal Allergy ◽  
Care Hospital ◽  
Prick Test ◽  
Younger Age ◽  
Dust Mite ◽  
Skin Prick Tests ◽  
The Common

Background: Allergic diseases are very common and are caused by allergen whose role varies according to climate changes. Not many studies are available regarding the same in our region. Skin prick test is a diagnostic procedure for allergy testing. The aim of the present study was to find out the seasonal variation of different allergies in our region.Methods: A total of 686 patients with allergic complaints were assessed for age and sex distribution, seasonal variation of number of allergy patients and seasonal variation of patient symptoms. 608 patients who gave consent and were found fit for skin prick tests underwent the tests and were analysed for allergy profile of the patients in different seasons.Results: The majority of patients were females and of younger age group. The majority of the patients had nasal symptoms and these symptoms were more in summer and rainy season during which pine mix and grass pollen were common allergens. Pulmonary symptoms were maximum in winters with dust mite and moulds being the common allergens. Dust mite was overall the most common allergen involved. Sensitization to allergens was less in winter months.Conclusions: This study focussed on seasonal variation of allergies and found pine mix and grass pollens to be major cause of nasal allergy and dust mite and mould mix to mainly cause pulmonary symptoms.

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