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Short and extended provocation tests have similar negative predictive value in non-immediate hypersensitivity to beta-lactams in children

dc.contributor.authorRegateiro, FS
dc.contributor.authorRezende, I
dc.contributor.authorPinto, N
dc.contributor.authorAbreu, C
dc.contributor.authorCarreiro-Martins, P
dc.contributor.authorGomes, ER
dc.date.accessioned2024-02-20T15:50:06Z
dc.date.available2024-02-20T15:50:06Z
dc.date.issued2019
dc.description.abstractIntroduction and objectives: Drug provocation tests (DPTs) are the gold-standard method to diagnose non-immediate hypersensitivity reactions (NIHSR) to beta-lactam antibiotics (BL) in children. Our aim was to compare the negative predictive value (NPV) of one-day (short) DPT versus 3-7 days (extended) DPT for the diagnosis of NIHSR to BL in paediatric age. A secondary aim was to compare confidence on drug re-exposure after short and extended negative DPTs. Methods: The occurrence of HSR on drug re-exposure and drug refusal after negative diagnostic DPTs were evaluated in children/adolescents with a history of NIHSR to BL using a questionnaire performed six months to ten years after DPT. Patients were divided into two groups according to the protocol performed: short DPT vs. extended DPT. Results: We enrolled 212 children and adolescents (86 females, 126 males, mean age at DPT 5.52 years, p25=3 years, p75=7.25 years): 69 tested with short DPT, and 143 with extended DPT. The NPV of both types of DPT together was 95.2%. The NPV of short DPT was 97.5% and the NPV of extended DPT was 93.8% (p=0.419). After negative DPT, beta-lactams were refused by carers in 14.75% of the children requiring subsequent treatment, 6.98% in the short DPT group and 18.99% in the extended DPT group (p=0.074). Conclusions: In our paediatric sample, prolonging drug administration did not increase the NPV of diagnostic DPT for NIHSR to BL or reduce drug refusal. Altogether, the data here reported suggest that, however intuitive, prolonging DPT is not beneficial in the parameters analysed.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAllergol Immunopathol (Madr) . 2019 Sep-Oct;47(5):477-483.pt_PT
dc.identifier.doi10.1016/j.aller.2019.01.004pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.4/2353
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectAlergénios/imunologiapt_PT
dc.subjectHipersensibilidade a Medicamentospt_PT
dc.subjectTestes de Provocação Brônquicapt_PT
dc.subjectBeta-lactâmicospt_PT
dc.subjectCriançapt_PT
dc.titleShort and extended provocation tests have similar negative predictive value in non-immediate hypersensitivity to beta-lactams in childrenpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage483pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPage477pt_PT
oaire.citation.titleAllergologia et Immunopathologiapt_PT
oaire.citation.volume47pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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