Division of Allergy and Immunology, Department of Pediatrics, Research and Training Hospital of Sakarya, Sakarya University, Medical Faculty, Adapazarı, Sakarya, Türkiye
Key words: Provocation, beta-lactam allergy, drug hypersensitivity reaction
*Corresponding author: Öner Özdemir, Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Sakarya University, Research and Training Hospital of Sakarya, Adnan Menderes Cad., Sağlık Sok., No: 195, Adapazarı, Sakarya, Türkiye. Email address: [email protected]
Received: 28 June 2024; Accepted 29 July 2024; Available online: 1 September 2024
Copyright: Özdemir Ö
License: This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/
Dear Editor,
I have read the article titled, “Safety of direct oral provocation test to delabel reported mild beta-lactam allergy in infants” by Cunha et al. with great interest.1 The authors of this article suggest that direct administration of the drug provocation test (DPT) without prior testing is a safe and effective method to detect Beta-lactam allergy, even in infants. Although this is a good and useful article, discussing a certain point in the table that has been missed out would help the reader understand the article better.
Characteristics of infants with positive DPT are given in Table 3 on page 3 of the article.1 Table 3 is not referenced in the text of the article, and it is not at all mentioned in the discussion.1 Drug hypersensitivity reaction due to beta-lactam allergy occurred on days 2–5 in these patients, and the reaction on DPTs occurred on days 1–2. Moreover, although only maculopapular exanthem was observed in these patients as a drug reaction, it is thought that an anaphylaxis-like reaction was observed in one case with the addition of gastrointestinal symptoms to the exanthem. I think these issues are important and discussing them with due importance will increase the overall value of this article.
In conclusion, I would like to thank the authors for this high-quality study and its results.
1. Cunha F, Cunha I, Gomes E. Safety of direct oral provocation test to delabel reported mild beta-lactam allergy in infants. Allergol Immunopathol (Madr). 2024; 52(2):10–15. 10.15586/aei.v52i2.887