Drug provocation tests (
DPTs) are gold standard to diagnose
drug allergy. Our goal was to evaluate the results and safety of diagnostic methods including
DPTs during childhood. Between January 2010 and February 2013
DPTs were performed and evaluated, prospectively, in children who attended our pediatric
allergy clinic with a suspected
drug hypersensitivity reaction. One hundred ninety-eight suspected
drug reactions in 175 patients (88 boys and 87 girls) were evaluated. The median age of the subjects at the time of the suspected
drug-induced
hypersensitivity reaction and at the time of the study was 56 (interquartile range [IQR] = 24-120 months) months and 76 (IQR = 35-149 months) months, respectively. Suspected drugs were
beta-lactam antibiotics in 108 cases (54.5%), non-
beta-lactam antibiotics in 22 cases (11.1%), and nonsteroid anti-inflammatory drugs in 52 cases (26.3%). The history was compatible with immediate-type reactions in 69 cases (34.8%). Skin-prick tests were not positive in any of the cases. Intradermal tests were positive in three cases (4%).
DPTs were positive in 13 (6.8%) of 191 provocation cases, which were performed with culprit drugs. Our results suggest that a positive clinical history is not enough to make a diagnosis of
drug allergy, which highlights the significance of undertaking further diagnostic evaluation especially for
DPTs.