Skin Test Reactions Associated with True Beta-Lactam Anaphylaxis and Allergy
February 10, 2026
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Candace Archie, Communications & Public Relations Manager
carchie@aaaai.org
(414) 272-6071
In the study, 15% of patients with a beta-lactam anaphylaxis had their allergy confirmed by skin test
Milwaukee, WI – Skin tests may provide clinical predictors for true beta-lactam anaphylaxis, according to new research being presented at the 2026 AAAAI Annual Meeting.
Researchers conducted a retrospective analysis of patients evaluated for beta-lactam anaphylaxis at Mayo Clinic sites in Arizona, Florida and Rochester from 2019 to 2020. The study variables included demographics, characteristics of index reaction history and skin test results. The researchers used multivariable logistic regression to assess the association between index reaction features, described as a reaction within one year, presence of urticaria, medical attention sought and epinephrine use. Researchers then confirmed an allergy by skin testing participants.
The study included 294 patients with a median age of 60 years old and demographics including 70% female, 92% White and 88% non-Hispanic. Of the participants evaluated for beta-lactam anaphylaxis labels, only 43 (15%) had beta-lactam allergy confirmed by a skin test. Penicillin was the most frequently implicated beta-lactam at 70%. Multivariable analysis showed that index reactions occurred within one year of evaluation (OR 11.35; 95%CI 3.70-37.98; p=.0001) and those wherein medical attention was sought (OR 2.41; 95%CI,1.19-5.13; p=.01) were associated with increased odds of a positive beta-lactam skin test. The presence of urticaria and epinephrine use was not significantly associated with skin test outcomes.
This research may help physicians identify clinical features that streamline beta-lactam allergy verification for patients.
Visit aaaai.org to learn more about penicillin allergy. Research presented at the 2026 AAAAI Annual Meeting, February 27 – March 2 in Philadelphia, PA, is published in an online supplement to The Journal of Allergy and Clinical Immunology (JACI).
The American Academy of Allergy, Asthma & Immunology (AAAAI) is the leading membership organization of more than 7,100 allergists, asthma specialists, clinical immunologists and other professionals with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI is the go-to resource for patients living with allergies, asthma and immune deficiency disorders.