About The Database
How to use this database:
All the medications in the database are presented using their generic names and are grouped into broad categories: antimicrobials, chemotherapeutic agents, biologicals, peri-operative agents, anticoagulants and coagulation factors, and others under miscellaneous. Within each category, medications are further divided into classes based on their classification, which considers their mechanism of action and/or molecular structure. For example, the category of antimicrobial agents encompasses classes such as penicillins, carbapenems, monobactams, cephalosporins, quinolones, tetracyclines, aminoglycosides, macrolides, anti-tuberculous drugs, antimalarials, antifungals and antivirals. You can start using the database by typing the specific drug’s generic name into the search bar (for instance, search for ‘acetaminophen’ rather than ‘Tylenol’). If the drug you are searching is not in the database, and you come across the non-irritating concentration in the literature, we highly encourage you to submit this information to our database via the feedback section. The sections on the skin prick testing (SPT) and intradermal (IDT) concentrations list non-irritating concentrations used for skin testing, with references provided in the “Skin testing reference” column. An asterisk next to any value signifies additional information, which can be found in the “Notes” section. If a published desensitization protocol exists for a particular drug, its citation can be found in the “Desensitization Protocol” section. The “Patch testing” section contains concentrations used for patch testing to assess delayed hypersensitivity reactions. Finally, the “Cross-reactivity” section highlights potential cross-reactivity between different drugs. As of now, the database has been updated with articles from the literature dating up until December 2023. If you published a non-irritating concentration for drug allergy testing or a new desensitization protocol after December 2023, we kindly invite you to submit this information to the database via the 'Feedback' tab. Submissions regarding patch testing concentrations or cross-reactivity data are equally welcomed.
How this database was created:
We initiated the creation of this database containing non-irritating concentrations based on the “Practice guidance for the evaluation and management of drug hypersensitivity” (Broyles AD et al, 2020 JACI In Practice). This initial database was then expanded through a thorough literature review of peer-reviewed articles in EMBASE, which helped identify published non-irritating drug concentrations used for skin testing in the assessment of drug hypersensitivities. In addition, we conducted extensive searches for published patch testing concentrations used for delayed hypersensitivity reactions, desensitization protocols (references only), and cross-reactivity information between drugs. We extracted relevant data from these articles and integrated them into our database. With Dr. Elizabeth Phillips’s permission, we also included patch testing concentrations from her practice. To date, our database comprises over 500 drugs and references to over 600 peer-reviewed articles.
Relevant Disclaimers:
This database includes drug concentrations for allergy skin testing as reported in existing literature and is intended to serve as a supplemental tool for allergists and other healthcare providers specializing in drug allergy assessment. However, it is at the discretion of physicians when deciding if allergy skin testing is appropriate, selecting a starting concentration for testing and interpreting the skin test results with clinical correlation. Except for penicillin, all other drug concentrations used for allergy skin testing are not standardized and have unknown positive predictive value (PPV) and negative predictive value (NPV). As such, negative allergy testing does not rule out a drug allergy and positive testing does not diagnose a drug allergy either. Furthermore, while compiling the database, transcription errors may have inadvertently occurred. If you suspect such an error, please notify us using the feedback button. The creators of this database hold no liability for errors or omissions of any kind in the content. The creators hold no liability for any losses or damages claimed to have resulted from the use of the content on this database, and users of the database must indemnify the creators for any expenses incurred if such claims are made. The creators will not be held liable to any user or third-party, including specifically any customer or patient of a user, for direct, special, indirect, incidental, or consequential damages. The database creators disclaim all warranties of any kind, including any warranty as to the quality, accuracy, comprehensiveness, and suitability for any particular purpose of the content.