Implementation of a Drug Allergy Testing Service in the Dermatology Outpatient Clinic of a Public University Hospital

Background: Investigation based solely on clinical history background is not sufficient to prove drug allergy and may lead to search for more expensive and potentially less effective alternative drugs. There are too few health centers that perform such tests in Brazil. Objectives: The aim of the present work was to structure and to systematize a service for in vivo drug skin testing in a public university hospital. Methods: The project was structured as follows: a) Divulgation about the service among health professionals and also among patients; b) Active search for suspicious cases; d) Referral to the allergist consultation; c) Performance of skin prick, intradermal and/or epicutaneous tests when requested. Results: Disclosure about the service was done through informal talk, workshop, flyers, advertisement. Active search for suspicious cases was done at the Dermatology Outpatient Clinics, Walter Cantídio Hospital School, Brazil. Ninety patients were evaluated by the allergist, and from these, 68 were submitted to drug skin tests. Thirty-five patients out of 68 presented clinical manifestations up to 2 h after drug intake and 33, more than 2h after drug intake. The drugs most implicated were NSAIDS and β-lactam drugs. Seventy-seven tests carried out. For immediate reading, 41 puncture tests and 12 intradermal tests were performed. For delayed reading, 24 epicutaneous tests were done. Two patients presented positive prick test to dipyrone. Conclusion: For implementing an adequate and effective service for drug skin testing, technical and practical training of health professionals about drug safety is necessary, besides interdisciplinary collaboration and an adequate support by the hospital managers.