If a patient had a non-anaphylactic IgE mediated reaction to Augmentin but can tolerate amoxicillin, would you directly proceed with an oral challenge to augmentin?

It is difficult to respond to this question, as “non-anaphylactic IgE-mediated reaction” is a bit vague. I assume this was an immediate cutaneous reaction with respiratory or cardiovascular manifestations. The issue, from my perspective, is that mild systemic reactions that appear to be IgE-mediated, usually based upon timing, could be more severe with subsequent administration. If there is no history of penicillin allergy and tolerance to amoxicillin was documented many months ago, there is a possibility of a newly developed sensitivity to the beta-lactam nucleus and/or aryl amino R1 side chain, or an IgE-mediated sensitivity to clavulanate. Torres-Rojas et al., PMID 37021506

If the patient did not have asthma, which increases the risk of s...