A questionnaire survey on the use of intracutaneous reaction tests at hospital pharmacies

In September 2004, when the precautions in the package inserts of injectable antibiotics were partially revised, the phrase "it is advisable to conduct an intracutaneous reaction test beforehand" or "conduct an intracutaneous reaction test beforehand" was deleted and replaced by precautions against allergic reactions and instructions to promptly deal with onsets of such reactions. However, intracutaneous reaction test solutions for injectable antibiotics are still manufactured and supplied to medical institutions. In this study, we conducted a questionnaire survey involving hospital pharmacies throughout Japan on their use of intracutaneous reaction tests and storage of intracutaneous reaction test solutions. In March 2010, we sent a written questionnaire by mail to 1,000 medical institutions with beds throughout Japan, which were extracted by region and the number of beds. We received answers from 448 institutions, comprised of 346 institutions which had stopped conducting intracutaneous reaction tests, 32 institutions which conducted tests in accordance with doctors' decisions and patients' history of allergy, and 25 institutions which basically conducted tests. The test implementation rate was higher at institutions with fewer beds and institutions without the ICT. A total of 158 institutions regularly stocked intracutaneous reaction test solutions. Among them, they stocked the solutions at an average of 12.6 items. Fifty-four institutions ordered the solutions as required. Thus, we observed that the majority of the hospital pharmacies used intracutaneous reaction test solutions and were faced with various associated problems. The Japanese Society of Chemotherapy also commented that "the use of intracutaneous reaction tests as a means to predict anaphylactic shock should be discontinued without delay". It is also necessary to appeal to the pharmaceutical industry to support the movement to stop using intracutaneous reaction test solutions.