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

  1. A. Romano1,2,
  2. M. Viola1,
  3. P. J. Bousquet3,
  4. F. Gaeta1,
  5. R. Valluzzi1,
  6. C. Caruso1,
  7. P. Demoly3

Article first published online: 6 DEC 2006

DOI: 10.1111/j.1398-9995.2006.01272.x

Issue

Allergy

Allergy

Volume 62, Issue 1, pages 53–58, January 2007

Additional Information

How to Cite

Romano, A., Viola, M., Bousquet, P. J., Gaeta, F., Valluzzi, R., Caruso, C. and Demoly, P. (2007), A comparison of the performance of two penicillin reagent kits in the diagnosis of β-lactam hypersensitivity. Allergy, 62: 53–58. doi: 10.1111/j.1398-9995.2006.01272.x

Author Information

  1. 1

    Department of Internal Medicine and Geriatrics, UCSC-Allergy Unit, Complesso Integrato Columbus, Rome, Italy

  2. 2

    IRCCS Oasi Maria S.S., Troina, Italy

  3. 3

    Exploration des allergies et INSERM U454, Hôpital Arnaud de Villeneuve, Montpellier Cedex, France

*Prof. Antonino Romano Department of Internal Medicine and Geriatrics Allergy Unit Complesso Integrato Columbus Via G. Moscati, 31 00168 Rome, Italy

Publication History

  1. Issue published online: 6 DEC 2006
  2. Article first published online: 6 DEC 2006
  3. Accepted for publication 11 October 2006

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Keywords:

  • β-lactams;
  • cephalosporins;
  • penicillins;
  • reagents;
  • skin tests

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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