In vivo and in vitro testing for adverse drug reactions

Adverse drug reactions are common and important problems for pediatric pharmacotherapy. Relatively few diagnostic tests can be used to confirm the diagnosis of adverse drug reactions and provide an estimate of the safety of future therapy. Oral challenge can be useful if performed under carefully controlled circumstances. Skin testing for selected compounds is the most useful and common diagnostic test used to assess adverse drug reactions. Other tests are available but are Limited in their clinical applicability; however, new developments in the understanding of the biology of adverse drug reactions offers the promise of refined and clinically relevant assays to diagnose adverse drug reactions and determine the safety of future therapy.