Table 2 Betalactam provocation test

Immediate reactions with negative skin tests

Graded challenge

1/10 TD (1/100 TD or 1/1000 TD when risk is high, e.g. severe asthma)

then 2/10 TD and 7/10 TD every 30 min

2 h observation after last dose

Delayed reactions

Graded challenge as DPT for immediate reactions, or a full-dose challenge. The daily therapeutic dose is given at home for a minimum of 5 days up to 7 days.

Positive skin tests Anaphylaxis

Desensitization