Does This Emergency Department Patient Have a Penicillin Allergy?
Methods
Data Sources
An English-language MEDLINE search from 1996 to 2000 was conducted, and the bibliographies were reviewed for additional references.
Study Selection
Original studies describing the accuracy or precision of skin testing in the diagnosis of an immunoglobulin E–mediated penicillin allergy were included. Fourteen studies met the inclusion criteria; 4 studies compared clinical history with skin test results in patients with and without a history of penicillin allergy.
Data Extraction and Synthesis
Confidence intervals for the likelihood ratios of having a positive skin test result, given a positive history of penicillin allergy, and having a negative skin test result, given a history of no penicillin allergy, were compared. Sensitivity and specificity for a history of penicillin allergy versus skin testing were also presented.
An installment of the Rational Clinical Examination Abstract series:
This is a Rational Clinical Examination abstract, a regular feature of the Annals' Evidence-Based Emergency Medicine (EBEM) series. Each features an abstract of a Rational Clinical Examination review from the Journal of the American Medical Association and a commentary by an emergency physician knowledgeable in the subject area. The source for this Rational Clinical Examination abstract is: Salkind AR, Cuddy PG, Foxworth JW. Is this patient allergic to penicillin: an evidence-based analysis. 2001;85(19):2498-05. The Annals EBEM editors assisted in the preparation of the abstract of this Rational Clinical Examination abstract.
PII: S0196-0644(09)01509-1
doi:10.1016/j.annemergmed.2009.08.025
© 2010 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
