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Table 1 Diagram for diagnosis of penicillin allergy

From: Accuracy in diagnosis of allergy to β-lactams

β-lactam Skin prick test (mg/ml) Intradermal (mg/ml) Provocation test (mg)
Penicillins PPL 5×10-5 mmol/l; MDM 2×10-2 mmol/l; penicillin G 20-25a As SPT 5, 25, 100, 250, 500
Aminopenicillins (amoxicillin, ampicillin, cloxacillin) Cephalosporins PPL 5×10-5 mmol/l; MDM 2×10-2 mmol/l; penicillin G 20-25a As SPT 5, 25, 100, 250, 500
   Oral (cefaclor, cefadroxil, cefixime, cefuroxime) 2-100 2a 5, 25, 125, 500
   Intravenous (cefazolin, ceftriaxone, ceftazidine) 2-100 2a 5, 25, 100, 500, 1,000
  1. Diagnosis was supported by skin test (ST) (skin prick and intradermal test) [5, 6], and if STs were negative by a single-blind drug challenge test (DChT) with increasing doses of the suspected drug [3, 4] every 60 minutes until the usual daily dose was administered or symptoms occurred (some of the symptoms previously described were present) [2]. If symptoms appeared more than 3 hours after the last dose of the DChT, a new DChT was proposed and scheduled. PPL, major determinant of penicillin (Diater Lab, Madrid, Spain); MDM, minor determinant mixture of penicillin (Diater Lab); SPT, skin prick test. aFrom Torres and colleagues [7].