IgE antibodies against penicillin as determined by Phadebas RAST

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Abstract
Serum samples from 81 patients with suspected penicillin allergy were investigated with Phadebas RAST [radioallergosorbent test] using the penicillin derivatives Benzylpenicilloyl-human serum albumin (PBO-HSA) and Phenoxymethylpenicilloyl-human serum albumin (PMPO-HSA); the results were compared with skin test results and clinical data. Of the 61 patients who had anaphylactic shock and/or urticaria as a possible consequence of penicillin administration, reagins against PBO-HSA and PMPO-HSA could be detected in 34 cases (56%). Of these patients with positive RAST results, 5% showed negative skin tests; in the other 95% RAST and skin tests were positive. All except 8 RAST-negative patients had adverse reactions at least 2 yr prior to the blood sampling and in some of these cases skin tests were also negative. RAST and provocation test results agreed in 80% of the cases where exposition was performed. The RAST technique is a valuable diagnostic tool for detection of immediate type hypersensitivity to penicillin.