Drug allergy: diagnosis and management

Reasons for the decision

New evidence was identified on the diagnosis of drug allergy in people with suspected antibiotic allergy. These diagnostic methods primarily focused on the use of skin tests (skin prick testing and intradermal testing) and oral challenge/drug provocation tests (DPTs) in children. Whilst the guideline does not explicitly include recommendations on the use of these tests, which are undertaken in a specialist setting, they were considered in the economic evidence used to inform section 1.4, covering referral to specialist drug allergy services. The evidence found during this surveillance review supports the use of skin tests and DPTs in diagnosing antibiotic allergy in children, however limited data was identified on the diagnostic performance of these tests. It was concluded that in the absence of further evidence synthesis or additional published studies, this evidence would not be sufficient to trigger an update at this time.

No new evidence was identified concerning the signs and symptoms of drug allergy, measuring serum specific immunoglobulin E or serum tryptase after suspected anaphylaxis in children. In addition, no new evidence was identified concerning the documentation and sharing of drug allergy information with other healthcare professionals, providing information and support to patients and non-specialist management and referral to specialist services.

For further details and a summary of all evidence identified in surveillance, see appendix A.