Positive results for only 18 percent of challenge tests to non-β-lactam antibiotics


Lisa Grinlington, M.B.B.S., from the Royal Children’s Hospital Melbourne in Australia, and colleagues describe the results of allergy evaluation among children with a suspected NBLA allergy who had skin testing and/or an intravenous or oral challenge test between May 2011 and June 2018. A total of 141 children had 150 allergy evaluations of 15 different NBLAs over the seven-year study period. The researchers found that time from the initial reported reaction to allergy evaluation was a median of 1.9 years. Overall, positive results were seen for 27 of 150 (18 percent) challenge tests to NBLAs, with the rate of positive oral challenge tests highest for trimethoprim-sulfamethoxazole and macrolides (32.6 and 10.4 percent, respectively). Initial anaphylactic reactions were reported for four children; however, no patients had severe symptoms on rechallenge or required adrenaline. Most children (23 of 27) with challenges with positive results had similar symptoms on repeat challenges to those initially reported.

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