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KMID : 1011320190110010037
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Journal of Pharmacoepidemiology and Risk Management
2019 Volume.11 No. 1 p.37 ~ p.43
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Cephalosporin Skin Test Positivity before Administration and Associated Factors
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Moon Mi-Ra
Kang Dong-Yoon
Lee Suh-Young
Yang Min-Suk
Lee Ju-Yeun
Kang Hye-Ryun
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Abstract
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Objective: Although it is not scientifically recommended due to lack of evidence, skin tests with cephalosporins have been conventionally performed prior to administration in most hospitals in Korea regardless of previous allergy to antibiotics. The aim of this study was to evaluate whether the result of cephalosporin skin test was affected by the history of allergic reactions in order to provide evidence to narrow down the range of subjects to perform cephalosporin skin test before use.
Methods: From October 2004 to June 2015, the electronic medical records of all the patients who were prescribed cephalosporin were reviewed to investigate whether previous history of allergic disease or drug allergy affect the skin test positivity.
Results: Among the total of 87,313 patients who underwent cephalosporin skin tests, 4,975 cases (5.70%) had a history of allergy and 1,139 cases (1.30%) presented positivity on cephalosporin skin test; the intersection of two groups was only 91 (7.99% of cephalosporin skin test positive cases) and 92.01% of cephalosporin skin test negative cases did not have previous allergy history. The positive rates of cephalosporin skin test were significantly different according to the presence or absence of comorbid allergy (1.83% vs. 1.27%, p=0.001). Patients with history of allergy to antibiotics also showed a higher positive rate (2.10% vs 1.30%) but this difference did not reach statistical significance (p=0.08).
Conclusion: Previous allergy history may affect the cephalosporin skin test result. However, most cases showing positivity to cephalosporin were free of allergy history. Therefore, previous allergy history is not an appropriate inclusion criteria to perform cephalosporin skin test.
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KEYWORD
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Hypersensitivity, Drug hypersensitivity, Cephalosporins, Skin tests, Intradermal tests
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