Drug Provocation Tests
The children underwent drug provocation tests (DPT) in case of mild or
moderate index HSRs if the initial SPT and IDT revealed negative
results. The patients were directly provoked with the culprit medication
when there was no parenteral form of the drug proper for SPT/IDT
(e.g.,NSAIDs) or there were no standard ST protocols established (e.g.
clarithromycin) (16). Oral form of the drug was preferred for DPT and
the doses and intervals were determined according to the established
protocols (17). The patient was administered the age- and
weight-adjusted total daily dose in four or five divided doses (14, 17).
The positive DPT was defined as the development of any objective
physical finding of a HSR concerning cutaneous (urticaria, maculopapular
rash, flushing which occurred during the DPT or within 48 hrs),
respiratory, gastrointestinal, and cardiovascular system (13, 14). For
non-immediate reactions, one day protocol was performed to protect
patients from longer exposure to antimicrobials.