Safety of cefuroxime as an alternative in patients with a proven hypersensitivity to penicillins: a DAHD cohort survey.

Objective: In patients sensitized to beta-lactams, a safe beta-lactam alternative is often needed. The objective was to assess the safety of cefuroxime in patients with a proven beta-lactam allergy.

Design: Using the Drug Allergy and Hypersensitivity Database cohort, patients with a proven beta-lactam allergy and tested for cefuroxime between September 1996 and April 2007 were selected.

Provocation tests in diagnosing drug hypersensitivity.

A position paper by the European Network for Drug Allergy (ENDA), the European Academy of Allergology and Clinical Immunology (EAACI) interest group on drug hypersensitivity, defines drug provocation tests (DPTs) as "the controlled administration of a drug in order to diagnose drug hypersensitivity reactions". The DPT is widely considered to be the "gold standard" to establish or exclude the diagnosis of hypersensitivity to a certain substance, as it not only reproduces hypersensitivity symptoms, but also any other adverse clinical manifestation, irrespective of the mechanism. The DPT can be harmful and thus should only be considered after balancing the risk-benefit ratio in the individual patient.