Do you still perform skin testing prior to giving IV antibiotic?

[plethoraldork]

I was wondering if it is still a practice to do skin test prior to administration of antibiotics in the hospital that you're working or if it's still effective?

[VickyRN, MSN, DNP, RN]

Short answer: no

[caroladybelle, BSN, RN]

Never have.It is rare to do sensitivity/allergy test doses with some the chemos that are known to be prone to hypersensitive reactions.

[Esme12, ASN, BSN, RN]

I have been a nurse for 33 years......I have NEVER seen this done in the US. Are you in the US?

[hudasalah]

dear all

i am a doctor, joined a hospital still performing this skin test, i need references to convince the nurses to stop this old practice

kindly help

[Esme12, ASN, BSN, RN]

dear all

i am a doctor, joined a hospital still performing this skin test, i need references to convince the nurses to stop this old practice

kindly help

Welcome to AN!

Dr....this is not done here in the US. I have been a nurse for 35 years and I have never done this. I am not sure we are able to help you...I can do some research and post it if you like....no promises I will find any thing....you might want to check other facilities in your areas and what they have done to deal with this.

[NurseOnAMotorcycle, ASN, RN]

I would talk to the hospital education team for some evidence based practice updates and maybe meet them half way with prn Benadryl orders...? Talk to the people who make policy if it's a hospital policy.

[canoehead, BSN, RN]

Never, and I'm in Canada.

[evolvingrn, BSN, RN]

never heard of it.

[kanzi monkey]

Have had a few patients with vaguely documented (and recalled) antibiotics allergies (usually pcn, but a few to quinolones) undergo skin testing followed by antibiotic challenge. Depending on the risk for anaphylaxis (determined by the allergist) this may require an ICU setting (for the challenge). Probably seen this done about 10 times, usually in situations when the infection is severe and there are few antibiotic options, or the allergy history is very unlikely. For many people out there, documented allergies to penicillin/cephalosporin, quinolones, sulfa, etc can be huge issues. It's a good thing to "rule out" an allergy. Also, I've never seen an allergy actually "ruled-in"--which is a telling thing, in my opinion.

In answer to the OP, yes, I've seen it done, but only on a select few cases. Definitely not for any given patient prior to starting an antibiotic (nope. You've got to EARN that allergy, lol). Fyi, I work in a large US teaching hospital.

[rogercarol2324]

Can anybody provide me with an evidence base policy about the non use of skin testing for any type drugs , specifically antibiotics?

[wtbcrna, MSN, DNP, CRNA]

[h=2]"The use of skin test to an antibiotic prior to its administration in a patient with no history of allergy to the drug in question[/h]

SEARCH AGAIN

Q:

7/17/2014

Is intradermal skin test indicated before giving injection ceftriaxone in a patient who is not aware or sure of previous allergic response to ceftriaxone or other betalactam antibiotics?

A:

Thank you for your inquiry.

No, antibiotic skin testing is not normally done in a patient without a history of a previous reaction to the drug in question. Here is a link to a brief discussion of this issue which presents some of the rationale underlying this practice.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,

Phil Lieberman, M.D."

The use of skin test to an antibiotic prior to its administration in a patient with no history of allergy to the drug in question

I don't have access to their journal, so I cannot provide you with the actual references.

[rogercarol2324]

Can I have a clear reference on it. I'm going to draft a policy . So I need supportive document about it. Tnx!!!!