title: Determining safe alternatives for multidrug hypersensitive patients with the alternative triple antibiotic-analgesic test.
abstract: BACKGROUND
  Drug provocation tests (DPTs) need technical equipment, staff and time. There are very few allergy centres performing DPTs in Turkey. Therefore many patients are referred to these centres. One day triple-double antibiotic or non-steroidal anti-inflammatory drug (NSAID) oral DPT for determining safe alternatives is safe, cost-effective and time saving compared to conventional one day one drug oral DPT. Our aim was to investigate the safety of antibiotic-NSAID oral DPT performed on the same day to find safe alternatives in multidrug hypersensitive patients.
  
  
  METHODS
  Forty-two patients who had been diagnosed as having both antibiotic and NSAID hypersensitivity were enrolled to the study between 15 November and 15 July 2010. The reactions were urticaria and/or angio-oedema not including laryngeal oedema for all patients. Two antibiotics-one NSAID or two NSAIDs-one antibiotic triple test have been performed on the same day to study patients (n=22), while the control group (n=20) had taken drugs on three separate days.
  
  
  RESULTS
  Only two patients had positive reactions during triple test and two patients had adverse reactions; one had gastric pain, one had nausea. Three patients in the control group had positive reactions. There were no significant differences between the two groups in frequency of adverse and allergic drug reactions (p>0.05). Sixty days were spent for the tests of the control group with only 28 days for the study population.
  
  
  CONCLUSIONS
  Triple test performed with antibiotic and NSAID on the same day for determining safe alternatives for multidrug hypersensitive patients reporting non-life-threatening allergic reactions seems to be safe and time-saving.
authors.affiliation: Hacettepe University, School of Medicine, Department of Chest Disease, Adult Allergy Unit, 06100 Ankara, Turkey. aysebilgeozturk@yahoo.com
authors.forename: A B
authors.initials: AB
authors.lastname: Ozturk
authors.forename: E
authors.initials: E
authors.lastname: Celebioglu
authors.forename: G
authors.initials: G
authors.lastname: Karakaya
authors.forename: A F
authors.initials: AF
authors.lastname: Kalyoncu
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects; D000799:Angioedema / Q000139:chemically induced; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003362:Cost-Benefit Analysis; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007159:Immunologic Tests / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014421:Turkey; D014581:Urticaria / Q000139:chemically induced; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal