Skin Testing before Antibiotic Administration - Is there a Scientific basis?

The practice of skin testing prior to administration of antibiotics in the absence of a history of allergy is non-existent in the western world. Reports on skin testing in the absence of known allergy are unheard of in the medical literature. The practice of giving a test dose prior to administration of the antibiotic is also practiced very sporadically and has no scientific basis. Despite this In India in most major institutions both in government and private hospitals , general practice set up and small and medium nursing homes, skin testing prior to administration of antibiotics remain extremely common and is even considered to be negligent if not practiced. In this review the evidence for skin testing and test dose before antibiotic administration has been examined. Based on the evidence available skin testing should be restricted to patients with a history of prior penicillin allergy for whom penicillin or other B-lactam antibiotic is the drug of choice and there is no suitable alternative.1 There is no need to do skin testing without a history of penicillin allergy even if the drug is to be administered parenterally. Test dose administration does not protect patients from anaphylactic reactions and hence the practice has no scientific basis.