TY - JOUR AU - Barbaud, Annick AU - Weinborn, Marie AU - Garvey, Lene Heise AU - Testi, Sergio AU - Kvedariene, Violeta AU - Bavbek, Sevim AU - Mosbech, Holger AU - Gomes, Eva AU - Aberer, Werner AU - Elberink, Hanneke N. G. Oude AU - Torres, Maria Jose AU - Ponvert, Claude AU - Ayav, C. AU - Gooi, Jimmy AU - Brockow, Knut PY - 2020 M3 - Original Research TI - Intradermal Tests With Drugs: An Approach to Standardization JO - Frontiers in Medicine UR - https://www.frontiersin.org/articles/10.3389/fmed.2020.00156 VL - 7 SN - 2296-858X N2 - Background: Intradermal tests (IDTs) are performed and interpreted differently in drug allergy centers making valid comparison of results difficult.Objective: To reduce method-related and intercenter variability of IDTs by the introduction of a standardized method.Materials and methods: In 11 centers of the European Network for Drug Allergy, IDTs were prospectively performed with saline and with amoxicillin (20 mg/ml) using (1) the local method and (2) the standardized European Network in Drug Allergy (ENDA) method (0.02 ml). The diameters of the initial injection wheal (Wi) for the different volumes and sites injected obtained from each center were analyzed.Results: The most reproducible method was to fill a syringe with test solution, then expel the excess fluid to obtain exactly 0.02 ml. The median Wi diameter with 0.02 ml injection using the standardized method was 5 mm [range 2–10 mm; interquartile range (IQR) 5–5 mm; n = 1,096] for saline and 5 mm (range 2–9 mm; IQR = 4.5–5 mm; n = 240) for amoxicillin. IDT injection sites did not affect the Wi diameter. Training improved precision and reduced the variability of Wi diameters.Conclusion: Using the standardized IDT method described in this multicenter study helped to reduce variability, enabling more reliable comparison of results between individuals and centers. ER -