Allergic drug reaction is an unintended side effect of a drug and it ranges from minor rash to life threatening reaction.
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Allergic drug reaction is an unintended side effect of a drug and it ranges from minor rash to life threatening reaction.
However, an allergy reaction to a drug is often misdiagnosed, over-diagnosed, or not reliably documented e.g. penicillin allergy. This becomes a problem when penicillin or related drugs e.g. Amoxycillin is essential and required by doctors to treat certain diseases and there is no better alternative. In such scenarios, a controlled allergy testing is required to see if the documented allergy is really true or not. If the testing shows that there is no allergy, then the drug can be safely used again.
There are 2 broad groups of drug allergy reaction and it is co-related to the time lapse of drug intake:
Skin Reaction |
Time Interval |
---|---|
Hives; shock with low blood pressure |
Typically within 1h, in rare cases up to 6h after exposure (immediate) |
Rash |
2-14 days after start of drug use (delay) |
Extensive Pustules (AGEP) |
1-12 days after start of drug use (delay) |
Extensive Blisters (SJS/TEN) |
4-28 days after start of drug use (delay) |
Rash with systemic symptom (DRESS) |
2-8 weeks after start of drug use (delay) |
Skin testing plays an important role in the diagnosis of allergy. Prick and intradermal test reactions are read and interpreted after 15 min. In the case of rash eruptions, late readings after 24, 48 or 72 hour may be necessary (e.g., when investigating amoxicillin eruptions). Sometimes, skin test reactions can even occur after more than 1 week.
Blood tests to measure specific IgE antibodies to a limited range of drugs (e.g. penicillin, amoxicillin) are available. However, it is not possible to conclusively detect or exclude drug allergy solely on the basis of blood tests.
Blood test results can only be interpreted together with patient history/clinical findings and possibly skin testing.
Provocation tests are necessary when the drug allergy cannot be identified with sufficient reliability on the basis of history, skin testing, and blood test investigations; and when the benefit of result obtained from provocation testing outweighs the risks. In cases of suspected and low likelihood of reactions to drugs that are essential (e. g., pain killers, antibiotics, local anesthetics), provocation tests are necessary and useful. In-patient medical supervision is required when provocation tests have the potential to trigger systemic reactions.
Call Assurance Skin Clinic at +65 6694 1121 for an appointment with Dr. Wong to evaluate your drug allergy and the need for allergy testing now.
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