AUTHOR=Barbaud Annick , Weinborn Marie , Garvey Lene Heise , Testi Sergio , Kvedariene Violeta , Bavbek Sevim , Mosbech Holger , Gomes Eva , Aberer Werner , Elberink Hanneke N. G. Oude , Torres Maria Jose , Ponvert Claude , Ayav C. , Gooi Jimmy , Brockow Knut 

TITLE=Intradermal Tests With Drugs: An Approach to Standardization

JOURNAL=Frontiers in Medicine

VOLUME=7

YEAR=2020

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.00156

DOI=10.3389/fmed.2020.00156

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> Intradermal tests (IDTs) are performed and interpreted differently in drug allergy centers making valid comparison of results difficult.</p><p><bold>Objective:</bold> To reduce method-related and intercenter variability of IDTs by the introduction of a standardized method.</p><p><bold>Materials and methods:</bold> In 11 centers of the European Network for Drug Allergy, IDTs were prospectively performed with saline and with amoxicillin (20 mg/ml) using (1) the local method and (2) the standardized European Network in Drug Allergy (ENDA) method (0.02 ml). The diameters of the initial injection wheal (Wi) for the different volumes and sites injected obtained from each center were analyzed.</p><p><bold>Results:</bold> The most reproducible method was to fill a syringe with test solution, then expel the excess fluid to obtain exactly 0.02 ml. The median Wi diameter with 0.02 ml injection using the standardized method was 5 mm [range 2–10 mm; interquartile range (IQR) 5–5 mm; <italic>n</italic> = 1,096] for saline and 5 mm (range 2–9 mm; IQR = 4.5–5 mm; <italic>n</italic> = 240) for amoxicillin. IDT injection sites did not affect the Wi diameter. Training improved precision and reduced the variability of Wi diameters.</p><p><bold>Conclusion:</bold> Using the standardized IDT method described in this multicenter study helped to reduce variability, enabling more reliable comparison of results between individuals and centers.</p>