Drug allergy in childhood

Abstract

Recently, in drug allergy, the importance of "de-labeling" (correcting a misdiagnosis of drug allergy) has been emphasized; further, careful and correct diagnosis is required. To diagnose immediate drug allergy, a skin prick test, an intradermal test, and a drug provocation test (DPT) are performed. A supplementary basophil activation test and drug-specific IgE test can be performed, although they are not covered by insurance in Japan. An intradermal test or patch test is performed for non-immediate drug allergy, followed by DPT. As regards the drug lymphocyte stimulation test, few reports provide evidence to recommend its use; further, caution is warranted while diagnosing drug allergy based on this result alone as it may lead to "wrong labeling". Herein, this paper will outline the definition and classification of drug allergy, the flow to DPT for diagnosis, and the detail of examination for antibiotic allergy, which is the frequent differential diagnosis.