A 5-year retrospective review of outpatient graded drug challenges

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In lieu of an abstract, here is the article's first paragraph:

Drug allergies are commonly over-reported. These inaccurate drug allergy labels adversely impact patient care because first-line medications are unnecessarily avoided. For penicillin allergy, use of second-line antibiotics is associated with increased adverse reactions, cost, hospital length of stay, and bacterial resistance in both children and adults.1, 2, 3 Despite the harm of unnecessarily avoiding first-line medications, there is limited validated diagnostic testing for drug allergy. Graded drug challenges (GDCs) are the gold standard for the diagnosis or exclusion of IgE-mediated drug allergy in the office, and delayed reactions outside of the office. GDCs consist of administering 1 to 3 doses of the medication in question over time.4 Although GDCs have an excellent safety record with no reported deaths, more data are required to better characterize GDCs.4



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