A comparison of the performance of two penicillin reagent kits in the diagnosis of β-lactam hypersensitivity

A. Romano, M. Viola, P. J. Bousquet, F. Gaeta, R. Valluzzi, C. Caruso, P. Demoly

Research output: Contribution to journalArticle

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Abstract

Background: Skin testing with penicilloyl polylysine (PPL) and minor determinant mixture (MDM) represents the first-line method for diagnosing β-lactam hypersensitivity. However, in 2004, Allergopharma and Hollister-Stier announced their decision to stop the production of penicillin reagents (Allergopen® and PrePen®, respectively) within 1 year. Therefore, we decided to compare PPL and MDM from Allergopharma (Allergopen) with those from Diater (DAP®). Methods: We skin-tested 195 subjects with both Allergopen and DAP reagents, as well as with other β-lactams; 74 (group A) had had immediate reactions to β-lactams and 74 (group B) nonimmediate reactions, while 47 (group C) underwent prophylactic tests. Results: One hundred two patients (52.3%) had positive skin tests; 29 (14.9%) were positive to PPL and/or MDM. Of the 102 skin-test-positive patients, 44 belonged to group A, 57 to B and 1 to C; the last was positive only to Allergopen PPL (PPL-A) and tolerated the benzylpenicillin challenge. Minor determinant mixture reagents produced identical results in the 148 patients of groups A and B, 22 (14.9%) of which were positive. Both PPL reagents produced negative results in 139 of these 148 patients and positive ones in 5; one subject was positive to DAP PPL (PPL-D) and negative to PPL-A, while three patients were positive to PPL-A and negative to PPL-D; two of the latter tolerated benzylpenicillin challenges. Conclusions: Minor determinant mixture reagents produced identical results in all 195 patients. Results of skin testing with PPL reagents were concordant in 190 (97.4%) of them. Therefore, DAP reagents are a reliable alternative to Allergopen ones.

Original languageEnglish
Pages (from-to)53-58
Number of pages6
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume62
Issue number1
DOIs
Publication statusPublished - Jan 2007

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Lactams
Penicillins
Hypersensitivity
Penicillin G
Skin Tests
Skin
penicilloyl polylysine

Keywords

  • β-lactams
  • Cephalosporins
  • Penicillins
  • Reagents
  • Skin tests

ASJC Scopus subject areas

  • Immunology

Cite this

A comparison of the performance of two penicillin reagent kits in the diagnosis of β-lactam hypersensitivity. / Romano, A.; Viola, M.; Bousquet, P. J.; Gaeta, F.; Valluzzi, R.; Caruso, C.; Demoly, P.

In: Allergy: European Journal of Allergy and Clinical Immunology, Vol. 62, No. 1, 01.2007, p. 53-58.

Research output: Contribution to journalArticle

Romano, A. ; Viola, M. ; Bousquet, P. J. ; Gaeta, F. ; Valluzzi, R. ; Caruso, C. ; Demoly, P. / A comparison of the performance of two penicillin reagent kits in the diagnosis of β-lactam hypersensitivity. In: Allergy: European Journal of Allergy and Clinical Immunology. 2007 ; Vol. 62, No. 1. pp. 53-58.
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AU - Romano, A.

AU - Viola, M.

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AU - Gaeta, F.

AU - Valluzzi, R.

AU - Caruso, C.

AU - Demoly, P.

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N2 - Background: Skin testing with penicilloyl polylysine (PPL) and minor determinant mixture (MDM) represents the first-line method for diagnosing β-lactam hypersensitivity. However, in 2004, Allergopharma and Hollister-Stier announced their decision to stop the production of penicillin reagents (Allergopen® and PrePen®, respectively) within 1 year. Therefore, we decided to compare PPL and MDM from Allergopharma (Allergopen) with those from Diater (DAP®). Methods: We skin-tested 195 subjects with both Allergopen and DAP reagents, as well as with other β-lactams; 74 (group A) had had immediate reactions to β-lactams and 74 (group B) nonimmediate reactions, while 47 (group C) underwent prophylactic tests. Results: One hundred two patients (52.3%) had positive skin tests; 29 (14.9%) were positive to PPL and/or MDM. Of the 102 skin-test-positive patients, 44 belonged to group A, 57 to B and 1 to C; the last was positive only to Allergopen PPL (PPL-A) and tolerated the benzylpenicillin challenge. Minor determinant mixture reagents produced identical results in the 148 patients of groups A and B, 22 (14.9%) of which were positive. Both PPL reagents produced negative results in 139 of these 148 patients and positive ones in 5; one subject was positive to DAP PPL (PPL-D) and negative to PPL-A, while three patients were positive to PPL-A and negative to PPL-D; two of the latter tolerated benzylpenicillin challenges. Conclusions: Minor determinant mixture reagents produced identical results in all 195 patients. Results of skin testing with PPL reagents were concordant in 190 (97.4%) of them. Therefore, DAP reagents are a reliable alternative to Allergopen ones.

AB - Background: Skin testing with penicilloyl polylysine (PPL) and minor determinant mixture (MDM) represents the first-line method for diagnosing β-lactam hypersensitivity. However, in 2004, Allergopharma and Hollister-Stier announced their decision to stop the production of penicillin reagents (Allergopen® and PrePen®, respectively) within 1 year. Therefore, we decided to compare PPL and MDM from Allergopharma (Allergopen) with those from Diater (DAP®). Methods: We skin-tested 195 subjects with both Allergopen and DAP reagents, as well as with other β-lactams; 74 (group A) had had immediate reactions to β-lactams and 74 (group B) nonimmediate reactions, while 47 (group C) underwent prophylactic tests. Results: One hundred two patients (52.3%) had positive skin tests; 29 (14.9%) were positive to PPL and/or MDM. Of the 102 skin-test-positive patients, 44 belonged to group A, 57 to B and 1 to C; the last was positive only to Allergopen PPL (PPL-A) and tolerated the benzylpenicillin challenge. Minor determinant mixture reagents produced identical results in the 148 patients of groups A and B, 22 (14.9%) of which were positive. Both PPL reagents produced negative results in 139 of these 148 patients and positive ones in 5; one subject was positive to DAP PPL (PPL-D) and negative to PPL-A, while three patients were positive to PPL-A and negative to PPL-D; two of the latter tolerated benzylpenicillin challenges. Conclusions: Minor determinant mixture reagents produced identical results in all 195 patients. Results of skin testing with PPL reagents were concordant in 190 (97.4%) of them. Therefore, DAP reagents are a reliable alternative to Allergopen ones.

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