Incomplete Diagnostic Testing for Many Drug Allergic Patients

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New data presented at the AAAAI annual meeting showed that a significant number of patients recommended to be evaluated for drug allergy never completed their diagnostic tests.

In recent findings presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2023 Annual Meeting in San Antonio, TX, investigators found that almost half of patients recommended for drug allergy diagnostics did not complete their tests.1

Drug allergies represent a significant source of illness and fatalities, and are consequently a common cause for patients to be referred to allergy and immunology specialists.

This research was authored by Gail Tan, MD, from Ohio State University College of Medicine.

Allergists frequently use skin testing and/or oral challenges to remove labels of patients. However, this process often necessitates a second appointment.

The investigators’ aim in their study was to determine the percentage of patients referred to a tertiary care academic allergy practice for drug allergy evaluation who completed the process.

In order to achieve this goal, the team conducted a single-year retrospective review of the medical records of all patients referred to our adult allergy clinic for drug allergy evaluation, gathering data on patients' demographics, drug allergy history, diagnostic evaluation recommendations, and challenge results.

The study evaluated 198 patients referred for drug allergy evaluation, of which 124 (63%) were recommended to undergo skin testing (ST) or oral challenges (OC).

The team added that the rest were cleared based on their medical history alone (n=40, 20%), advised to avoid the drug due to likely allergy (24, 12%), referred for desensitization (4, 2%), or received multiple recommendations that did not require follow-up (6, 3%).

The investigators concluded that antibiotics were the leading cause of drug allergy referrals, accounting for 53% of cases.

The team additionally noted 91% of patients who completed their diagnostic visit were successfully de-labeled of the drug allergy.

Of those recommended for follow-up, only 61% completed the OC or ST visit, with 69% of those who did not complete their tests failing to schedule the appointments.

The investigators concluded that further strategies may be necessary to identify and minimize follow up barriers for these kinds of patients.


  1. Tan G. Proportion of Referred Patients Who Completed Recommended Drug Allergy Evaluation. J Allergy Clin Immunol. 2023 Feb;151(2 Suppl):AB61. doi: 10.1016/j.jaci.2022.12.194.