To challenge or not to challenge: Literature data on the positive predictive value of skin tests to beta-lactams
Résumé
The aim of the present study was to investigate data related toPPV of STs to BLs. We performed a literature review in thePubMed database, by cross-referencing the terms“skin test,”“beta-lactam,”and“drug hypersensitivity,”to retrieve availableliterature data on the PPV of STs to BLs. We included articles inEnglish and French published between 1966 and 2017. Refer-ences of selected articles were reviewed for additional sources.Reports concerning patients with positive ST results wereretrieved and analyzed. These reports included the following 4clinical situations that we considered would prove the“allergy-revealing”(rather than just“sensitization-revealing”) value of apositive ST result to BL, assuming that concentrations used arethe nonirritant published ones1,2: (1) re-administration (eitheraccidental or by drug provocation test [DPT]) of the culprit, ST-positive BL; (2) systemic drug hypersensitivity reaction (DHR)occurring during positive BL ST result; (3) administration (eitheraccidental or by DPT) of a supposedly side-chain cross-reactiveBL based on known side-chain similarities; and (4) DHRoccurring during a desensitization protocol performed in ST-positive patients.
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