title: Nonirritant intradermal skin test concentrations of ciprofloxacin, clarithromycin, and rifampicin.
abstract: BACKGROUND
  Intradermal skin testing of the clinically important antibiotics ciprofloxacin, clarithromycin, and rifampicin in the case of suspected allergies to antibiotics is poorly standardized. For clinical practice, standardized procedures and protocols are desired.
  
  
  METHODS
  Fifteen healthy volunteers were tested with different concentrations of the antibiotics as well as with appropriate controls. Test readings included wheal area measured by digital image analysis and blood flow increase measured by laser Doppler flowmetry (LDF). To reduce interpersonal variability, test results were normalized with the individual controls using a novel protocol.
  
  
  RESULTS
  Nonirritating concentrations of the three antibiotics (ciprofloxacin ~0.0067 mg/ml, clarithromycin ~0.05 mg/ml, rifampicin ~0.002 mg/ml) could be defined for healthy volunteers. Laser Doppler flowmetry generates comparable results to wheal area measurement. Normalization of the test results is necessary and can be applied in a practical algorithm.
  
  
  CONCLUSIONS
  Standardized skin testing to detect sensitization to broadly used nonbetalactam antibiotics was presented and should be applied in truly sensitized patients. This approach should help to minimize the inter- and intraindividual differences in reactivity.
authors.affiliation: Department of Angiology, University Hospital, Basel, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Brož
authors.forename: Th
authors.initials: T
authors.lastname: Harr
authors.forename: C
authors.initials: C
authors.lastname: Hecking
authors.forename: L
authors.initials: L
authors.lastname: Grize
authors.forename: K
authors.initials: K
authors.lastname: Scherer
authors.forename: K A
authors.initials: KA
authors.lastname: Jaeger
authors.forename: A J
authors.initials: AJ
authors.lastname: Bircher
mesh_terms: D000328:Adult; D000485:Allergens / Q000008:administration & dosage* / Q000276:immunology; D002939:Ciprofloxacin / Q000008:administration & dosage* / Q000276:immunology; D017291:Clarithromycin / Q000008:administration & dosage* / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000276:immunology; D012293:Rifampin / Q000008:administration & dosage* / Q000276:immunology; D015927:Skin Test End-Point Titration / Q000592:standards; D055815:Young Adult
chemical_list: D000485:Allergens; D002939:Ciprofloxacin; D017291:Clarithromycin; D012293:Rifampin