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Discussion

skin test

I'm a nurse from a Southeast Asian country, we do skin test on our patients before administering the antibiotic that was ordered to be given to them. I was wondering if this is also practiced in other countries? If not, how can you know if the patient is allergic on the medication that was ordered?

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I'm a nurse from a Southeast Asian country, we do skin test on our patients before administering the antibiotic that was ordered to be given to them. I was wondering if this is also practiced in other countries? If not, how can you know if the patient is allergic on the medication that was ordered?

That's a good question. For the most part, where I work we just take the patient's word that they are or aren't allergic to a medication. Maybe twice a year I'll have a patient that says they are allergic to some antibiotic but can't remember the name of it. I just do a test dose of 0.25 ml IV with benadryl ready before giving the full 250ml mini-bag of ordered antibiotic. If they start getting itchy (never happened yet) I can give benadryl right away.

I'm a nurse from a Southeast Asian country we do skin test on our patients before administering the antibiotic that was ordered to be given to them. I was wondering if this is also practiced in other countries? If not, how can you know if the patient is allergic on the medication that was ordered?[/quote']

Never seen a skin test done before routine antibiotics here in the U.S. The only thing I have seen skin testing done for is TB and allergy testing (for diagnosing purposes in an allergy office, not in a hospital)

There are a few medications that we do perform skin tests on prior to administration or a small test dose that is given IV. These are IV medications that have a high chance of a hypersensitivity reaction. The two I have seen commonly are Amphotericin and IV iron compounds. There are a few more but I cannot think of them now. We have protocols in place for hypersensitivity reactions and we can stop the medication and treat the reaction ASAP without first having to call the MD. We call them after we have treated the patient.

I recall this question being asked once before here - and that poster was also from southeast Asia. It seems to be a practice limited to certain countries.

Speaking generally, I would say that in the US the priority is rapid initiation of antibiotics ... so we generally do not wait for allergy testing.

Canada here. In a few isolated cases we have done the "small test dose" with Benadryl on standby, but generally we go with the patient's word about what they are/are not allergic.

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my clinical instructor taught me about giving a small test dose thru IV, but I can't exactly recall it since we rarely do that esp. in the hospitals here. How many ml do I need for the test dose? and How can I assess if it is positive or not? will I check for redness and ask for er itchiness?

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