Diagnostic Accuracy of Skin Test in Patients With Cefaclor-Induced Anaphylaxis.

BACKGROUND

The frequency of cefaclor-induced immediate hypersensitivity reactions has increased in Korea. Skin prick tests (SPTs) and intradermal tests (IDTs) using cephalosporins are not as well validated as those using penicillin. Limited data are available regarding the diagnostic value of SPTs and IDTs for cefaclor-induced immediate hypersensitivity reactions.

OBJECTIVE

To compare the clinical utility of the SPT and IDT with that of the ImmunoCAP test in patients with cefaclor-induced immediate hypersensitivity reactions.

METHODS

We conducted a retrospective analysis of participants from a tertiary hospital in Korea with a history of suspected immediate hypersensitivity reaction to cefaclor who had undergone SPT, IDT, and ImmunoCAP.

RESULTS

A total of 155 patients with a diagnosis of cefaclor-induced immediate hypersensitivity reactions were included in the analysis. Of those, 81 patients tested positive for both the SPT/IDT and the ImmunoCAP test. Sixty patients were positive for the SPT/IDT but negative for the ImmunoCAP test. Seven patients tested positive only for the ImmunoCAP test. Positivity for SPT/IDT and that for SPT were significantly higher in cases of anaphylaxis compared with urticaria; however, ImmunoCAP positivity did not differ based on the severity of the reaction.

CONCLUSIONS

Skin prick tests and IDTs are more sensitive than ImmunoCAP for diagnosing cefaclor-induced immediate hypersensitivity reactions, particularly in cases of anaphylaxis. The positivity of SPT/IDT varies depending on the severity of the hypersensitivity reaction. Therefore, SPT/IDT should be considered for diagnosing cefaclor-induced anaphylaxis.