Q:

9/26/2012
We routinely challenge our (-) penicillin testing with 250-mg Amoxicillin. Should we be challenging all other drugs (cephalosporins, fluoroquinolones, etc)? Thank you.

A:

Thank you for your inquiry.

Oral challenges to drugs are usually only done when the following criteria are met:

1. There is reason to expect that the patient is at increased risk of an adverse reaction if they take the drug in question. The most common scenario in this regard of course is a history of a previous reaction.

2. There is a need for the drug to be given. In most instances that need is imminent.

In the absence, therefore, of a history of a previous reaction to the drug, and no immediate need for the drug, drug challenges are usually not performed.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology