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Clinical and Translational Allergy

Open Access

Inclusion of clavulanic acid determinants in the basophil activation test improves the evaluation of immediate reactions to amoxicillin-clavulanic acid

  • Tahia D Fernandez1,
  • Adriana Ariza2,
  • Maria Salas3,
  • Maria I Montañez1,
  • Inmaculada Doña3,
  • Lidia Melendez1,
  • Maria D Cañamero3,
  • Miguel Blanca3,
  • Maria J Torres3 and
  • Cristobalina Mayorga1
Clinical and Translational Allergy20144(Suppl 3):P32

Published: 18 July 2014


PenicillinPromising ResultAntibiotic TherapyAmoxicillinAllergic Reaction


The clavulanic acid (CLV) is nowadays frequently included in the treatment with Amoxicillin (AX). This component of the antibiotic therapy initially thought to have a low immunogenic capacity; however immediate allergic reactions to CLV have been reported in a 30% of patients allergic to AX-CLV. Basophil activation test (BAT) has shown promising results demonstrating specific recognition of CLV determinants. The aim of this study was to assess the value of BAT in the evaluation of immediate allergic reactions to CLV.


Patients with a strong clinical history of having suffered an immediate reaction after AX-CLV administration were evaluated. The allergological study followed the European Academy guidelines, included skin test with penicillin G, AX, and CLV determinants and drug provocation test when indicated. BAT was carried out using AX and CLV at different concentrations (2.5, 1.25, 0.25 and 0.05 mg/ml).


Among 75 patients included, 64 were finally diagnosed as allergic, 26 to AX and 38 to CLV. The sensitivity of BAT was 60% and the specificity 81.8%. The inclusion of AX determinant produced a BAT sensitivity of 54.1% whereas CLV determinant produced a BAT sensitivity of 78.6% with a specificity of 91% and 82% respectively. In patients diagnosed as allergic to AX the BAT sensitivity was 50% whereas in patients allergic to CLV, BAT sensitivity was 65.8%.


The inclusion of clavulanic acid in the basophil activation test increases its diagnostic capacity in patients with immediate allergic reaction to the combination amoxicillin-clavulanic acid.

Authors’ Affiliations

IBIMA-Regional University Malaga Hospital-UMA, Research Laboratory, Spain
IBIMA-Regional University Malaga Hospital-UMA, Allergy Service, Spain
Regional University Malaga Hospital, Allergy Service, Spain


© Fernandez et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.