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Allergo Journal International

, Volume 27, Issue 1, pp 40–42 | Cite as

Correction to: Guideline for the diagnosis of drug hypersensitivity reactions

  • Knut Brockow
  • Bernhard Przybilla
  • Werner Aberer
  • Andreas J. Bircher
  • Randolf Brehler
  • Heinrich Dickel
  • Thomas Fuchs
  • Thilo Jakob
  • Lars Lange
  • Wolfgang Pfützner
  • Maja Mockenhaupt
  • Hagen Ott
  • Oliver Pfaar
  • Johannes Ring
  • Bernhardt Sachs
  • Helmut Sitter
  • Axel Trautmann
  • Regina Treudler
  • Bettina Wedi
  • Margitta Worm
  • Gerda Wurpts
  • Torsten Zuberbier
  • Hans F. Merk
Correction
  • 376 Downloads

Correction to:

Allergo J Int 2015

DOI  https://doi.org/10.1007/s40629-015-0052-6

In the original published version, Tab. 4, first two lines, the names of the in Europe currently comercially available ß‑Lactam antibiotics were not given correctly. Furthermore, the corresponding values of the prick test and intradermal test concentrations were published wrongly. The correct table is given here.

Suspected drug hypersensitivity reactions require allergological investigation in order, firstly, to prevent severe reactions upon renewed exposure or, secondly, to avoid unnecessary drug restrictions. Skin tests are important to detect sensitization to drugs. The methods described by the European Network on Drug Allergy (ENDA) in several guidelines and position papers are currently recommended. In 2003, an error concerning testing for beta-lactam allergy found its way into these recommendations stating incorrect test concentrations for the two commercial penicillin test kits available in Europe at that time [1]; this error was then copied in several position papers [2, 3, 4], as well as in the “Guideline for the diagnosis of drug hypersensitivity reactions” [5]. In these documents, reagent concentrations were incorrectly expressed in mmol/L, instead of mol/L. Regarding the available commercial test kits, one producer has discontinued the production of their kits (Alleropen, Allergopharma, Germany). The other test kit was modified in 2012 and is available since then with a higher purified formulation of the major determinant benzylpenilloyl-octa-L-lysine instead of benzylpenilloyl-poly-L-lysine and improved stability using sodium benzylpenicilloate as the single minor determinant instead of a minor determinant mixture (DAP® Kit, Diater, Madrid, Spain). It is currently the only commercially available test kit in Europe.

The correction relates to the major determinant (benzylpenicilloyl octa-L-lysine) and the minor determinant (sodium benzylpenilloate). They are present following reconstruction in 1 ml solvent at concentrations of 8.6 × 10−5 mol/L (related to eight benzylpenicilloyl moieties) and 1.5 × 10−3 mol/L (for sodium benzylpenilloate) and not, as given in the relevant overview articles, 5 × 10−5 mM penicilloyl poly-L-lysine and 2 × 10−2 mM for the minor determinant mixture. Thus, the data in Table 4 need to be corrected accordingly. Compliance with the written instructions enclosed with the DAP® Penicillin Test Kit automatically yields the correct test concentrations. The corrected version of Table 4 can be found above.
Table 4

Non-irritant skin test concentrations of frequently tested drugs [4]

Drug or drug class

Prick test

Intradermal testh

Patch test

ß-Lactam antibiotics

Benzylpenicilloyl-octa-L-lysine

8.6 × 10 −5 mol/L

8.6 × 10 −5 mol/L

NA

Sodium benzylpenilloate

1.5 × 10 −3 mol/L

1.5 × 10 −3 mol/L

NA

Benzylpenicillin

10,000 IU/ml

10,000 IU/ml

5%

Amoxicillin

20 mg/ml

20 mg/ml

5%

Ampicillin

20 mg/ml

20 mg/ml

5%

Cephalosporins

2 mg/ml

2 mg/ml

5%

Anticoagulants

Heparinsa

Undilutedh

1/10 diluted

Undilutedh

Heparinoidsb

Undilutedh

1/10 diluted

Undilutedh

Platinum salts

Carboplatin

10 mg/ml

1 mg/ml

NA

Oxaliplatin

1 mg/ml

0.1 mg/ml

NA

Cisplatin

1 mg/ml

0.1 mg/ml

NA

NSAIDs

Pyrazolonesc

Suspensioni

0.1–1 mg/ml

10%

Coxibsd

Suspensioni

NA

10%

Other NSAIDe

Suspensioni

0.1–1 mg/ml

10%

Biologicals

Adalimumab

50 mg/ml

50 mg/ml

Undilutedh

Etanercept

25 mg/ml

5 mg/ml

NA

Infliximab

10 mg/ml

10 mg/ml

NA

Omalizumab

1.25 μg/ml

1.25 μg/ml

NA

Others

Local anesthetics

Undilutedh

1/10 diluted

Undilutedh

Iodinated contrast media

Undilutedh

1/10 diluted

Undilutedh

Gadolinium chelates

Undilutedh

1/10 diluted

NA

Patent blue

Undiluted

1/10 diluted

NA

Methylene blue

Undiluted

1/100 diluted

NA

Fluorescein

Undilutedh

1/10 diluted

Undilutedh

Proton pump inhibitorsf

Undilutedh

40 mg/ml

10%

Anticonvulsantsg

NA

NA

10%

Chlorhexidine digluconate

5 mg/ml

0.002 mg/ml

1%

NA not applicable or no recommended concentration, NSAID non-steroidal anti-inflammatory drugs

aHeparins: unfractionated heparin, nadroparin, dalteparin, enoxaparin; testing contraindicated in heparin-induced thrombocytopenia

bHeparinoids: danaparoid, fondaparinux

cPyrazolones: metamizole, propyphenazone, aminopyrine, phenazone, phenylbutazone

dCoxibs: celecoxib, etoricoxib, valdecoxib

eOther NSAIDs: e. g., aspirin, ibuprofen, naproxen, indomethacin, diclofenac, fenoprofen, meloxicam, mefenamic acid, nimesulide

fNo intravenous solution available for intradermal testing with lansoprazole and rabeprazole, only for prick testing

gTest initially with 1% in the case of severe reactions

hUse of the commercially available solution for intravenous infusion or subcutaneous injection

iTablet is ground to a powder and a suspension prepared using physiological saline solution

References

  1. 1.
    Torres MJ, Blanca M, Fernandez J, Romano A, Weck A, Aberer W, et al. Diagnosis of immediate allergic reactions to beta-lactam antibiotics. Allergy. 2003;58:961–72.CrossRefPubMedGoogle Scholar
  2. 2.
    Romano A, Blanca M, Torres MJ, Bircher A, Aberer W, Brockow K, et al. Diagnosis of nonimmediate reactions to beta-lactam antibiotics. Allergy. 2004;59:1153–60.CrossRefPubMedGoogle Scholar
  3. 3.
    Blanca M, Romano A, Torres MJ, Fernandez J, Mayorga C, Rodriguez J, et al. Update on the evaluation of hypersensitivity reactions to betalactams. Allergy. 2009;64:183–93.CrossRefPubMedGoogle Scholar
  4. 4.
    Brockow K, Garvey LH, Aberer W, Atanaskovic-Markovic M, Barbaud A, Bilo MB, et al. Skin test concentrations for systemically administered drugs—an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy. 2013;68:702–12.CrossRefPubMedGoogle Scholar
  5. 5.
    Brockow K, Przybilla B, Aberer W, Bircher AJ, Brehler R, Dickel H, et al. Guideline for the diagnosis of drug hypersensitivity reactions: S2K-Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Dermatological Society (DDG) in collaboration with the Association of German Allergologists (AeDA), the German Society for Pediatric Allergology and Environmental Medicine (GPA), the German Contact Dermatitis Research Group (DKG), the Swiss Society for Allergy and Immunology (SGAI), the Austrian Society for Allergology and Immunology (ÖGAI), the German Academy of Allergology and Environmental Medicine (DAAU), the German Center for Documentation of Severe Skin Reactions and the German Federal Institute for Drugs and Medical Products (BfArM). Allergo J Int. 2015;24:94–105.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  • Knut Brockow
    • 1
  • Bernhard Przybilla
    • 2
  • Werner Aberer
    • 3
  • Andreas J. Bircher
    • 4
  • Randolf Brehler
    • 5
  • Heinrich Dickel
    • 6
  • Thomas Fuchs
    • 7
  • Thilo Jakob
    • 8
  • Lars Lange
    • 9
  • Wolfgang Pfützner
    • 10
  • Maja Mockenhaupt
    • 11
  • Hagen Ott
    • 12
  • Oliver Pfaar
    • 13
  • Johannes Ring
    • 1
  • Bernhardt Sachs
    • 14
  • Helmut Sitter
    • 15
  • Axel Trautmann
    • 16
  • Regina Treudler
    • 17
  • Bettina Wedi
    • 18
  • Margitta Worm
    • 19
  • Gerda Wurpts
    • 20
  • Torsten Zuberbier
    • 19
  • Hans F. Merk
    • 20
  1. 1.Department of Dermatology and Allergology am BiedersteinTechnische Universität MünchenMunichGermany
  2. 2.Department of Dermatology and Allergology, Allergy CenterLudwig Maximilian University of MunichMunichGermany
  3. 3.Department of DermatologyMedical University of GrazGrazAustria
  4. 4.Department of AllergologyUniversity Hospital BasleBaselSwitzerland
  5. 5.Department of DermatologyMünster University HospitalMünsterGermany
  6. 6.Department of Dermatology, Venereology and Allergology, St. Josef HospitalRuhr University BochumBochumGermany
  7. 7.Department of Dermatology, Venereology and AllergologyGöttingen University HospitalGöttingenGermany
  8. 8.Department of Dermatology and VenereologyFreiburg University HospitalFreiburgGermany
  9. 9.Department of PediatricsMarien HospitalBonnGermany
  10. 10.Department of Dermatology and AllergologyGießen and Marburg University HospitalMarburgGermany
  11. 11.German Center for the Documentation of Severe Skin Reactions, Department of Dermatology and VenereologyFreiburg University HospitalFreiburgGermany
  12. 12.Children’s and Adolescents’ Hospital “Auf der Bult”HannoverGermany
  13. 13.Center for Rhinology and AllergologyENT at Mannheim University HospitalWiesbadenGermany
  14. 14.Federal Institute for Drugs and Medicinal ProductsBonnGermany
  15. 15.Institute of Theoretical SurgeryPhilipps UniversityMarburgGermany
  16. 16.Department of Dermatology and Allergology, Mainfranken AllergyWürzburg University HospitalWürzburgGermany
  17. 17.Department of Dermatology, Venereology and AllergologyLeipzig UniversityLeipzigGermany
  18. 18.Department of Dermatology, Venereology and AllergologyHannover Medical UniversityHannoverGermany
  19. 19.Department of Dermatology, Venereology and AllergologyCharité University HospitalBerlinGermany
  20. 20.Department of Dermatology and AllergologyRTWH AachenAachenGermany

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