Skin Prick Test as a Provocation Test - Severe Anaphylactic Reaction to Skin Tests with Ceftriaxone in Two Occupationally Exposed Workers

Two patients are presented who were evaluated for bronchial asthma due to occupational exposure to ceftriaxone. In both, an anaphylactic reaction occurred within minutes after application of a prick test with ceftriaxone, requiring epinephrine administration. Systemic reactions to skin tests with beta-lactam antibiotics are relatively rare and may occur in patients with antecedent mild symptoms such as urticaria or occupational contact allergies to beta-lactams. Risk factors include a history of severe anaphylaxis and a short reaction interval. It is imperative to pay attention to the correct performance of skin tests with titration and adequate monitoring of the patient.