title: Oral drug provocation test to generate a list of safe drugs: experience with 100 patients.
abstract: BACKGROUND
  Following a drug eruption, patients and their doctors need to know which drugs can be safely administered for subsequent illnesses. Currently available laboratory tests are unable to answer this question in a clinically meaningful manner.
  
  
  OBJECTIVE
  To describe our use of oral provocation tests to provide a list of safe drugs to patients.
  
  
  METHODS
  We studied the records of 100 patients who underwent oral provocation testing in our department between 2003 and 2009. All patients were admitted to hospital and drugs were administered under supervision, one drug per day. A dermatologist evaluated all symptoms and signs that developed following drug intake.
  
  
  RESULTS
  Sixty nine women and 31 men underwent provocation testing. There were 96 reactions in 61 patients, of which 44 reactions in 34 patients were judged to be true reactions. All reactions could be controlled, with treatment or spontaneously. A list of safe drugs was provided to the patient along with written instructions to avoid any drug(s) that had produced a reaction.
  
  
  CONCLUSIONS
  Oral provocation tests are safe and effective in providing patients with a list of drugs they can take safely. These tests should preferably be undertaken after admitting the patient to hospital.
authors.affiliation: Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: M
authors.initials: M
authors.lastname: Ramam
authors.forename: Uttam
authors.initials: U
authors.lastname: Kumar
authors.forename: Radhakrishna
authors.initials: R
authors.lastname: Bhat
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Sharma
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000563:Amebicides / Q000008:administration & dosage / Q000819:agonists; D000799:Angioedema / Q000139:chemically induced; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D019937:Diagnostic Techniques and Procedures; D003875:Drug Eruptions / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007917:Leprostatic Agents / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013262:Stevens-Johnson Syndrome / Q000209:etiology; D055815:Young Adult
chemical_list: D000563:Amebicides; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000995:Antitubercular Agents; D007917:Leprostatic Agents