부산대학교 도서관

Backgrounds: Although the data on validity of skin test with drugs expect for penicillin is still scarce, positive skin reaction at non-irritating concentrations with relevant history is generally accepted for diagnosis of drug allergy. In this study, we investigated the maximal non-irritant drug concentrations for intradermal skin test with commonly prescribed antibiotics in Korean adults. Methods: Sixty one healthy volunteers were recruited. Seventeen parenteral antibiotics including beta-lactams and fluoroquinolones were evaluated. The maximal concentration of antibiotics was investigated by two steps as following; A) Intradermal skin test were repeatedly performed from full strength concentration of each drug and, if the result was positive, then serially diluted concentration till the result was negative in the first volunteer; B) establishing the nonirritating concentration identified in step A in 19 more subjects. All subjects were allowed to participate in multiple testing using different drugs. The established maximal nonirritating concentration for each type of antibiotics from this study were compared with a ‘known nonirritating concentration’ of each drug from the previous studies. Results: The mean age of the subjects is 35.0 and there were more females (77%) than males. The maximal nonirritating concentrations for ampicillin/sulbactam, aztreonam, ciprofloxacin, clindamycin, nafcillin and penicillin G from this study were comparable with the known nonirritating concentration of each agent. The maximal nonirritating concentrations of cephalosporins except for ceftriaxone were different from those from previous studies. In addition, the discrepancy between previous known concentrations and the values from this study was 10-fold and more for azithromycin, levofloxacin, meropenem, piperacillin/tazobactam, SMT/TMP, and vancomycin. The difference in nonirritating concentration among volunteers were greater than 100 fold for cefotetan, azithromycin, and vancomycin. Conclusions: To improve the reliability of skin test, study with the numerous subjects would be necessary to standardize non-irritating drug concentration for skin test.