Objective: Drug hypersensitivity reactions (DHRs) refer to unpredictable and dose-independent reactions to medications. The gold standard diagnostic method for drug allergies is the drug provocation testing. This study aimed to retrospectively evaluate the clinical characteristics, culprit drug classes, diagnostic approaches, and management strategies of DHRs.

Materials and Methods: Medical records of 260 patients evaluated for immediate drug hypersensitivity reactions during the defined study period, October 2023 - June 2025, were reviewed retrospectively. Demographic characteristics, suspected drugs, reaction patterns, severity grading, and oral challenge test results were analyzed.

Results: The study included 260 patients with 511 suspected drug reactions. The median age was 41.23± 12.94 (min: 18, max: 72) with a female predominance. Oral administration accounted for 82.7% of the responses, with nonsteroidal anti-inflammatory drugs being the most common culprit drug group (45.8%). In immediate reactions, skin symptoms were predominantly urticaria (91.2%) and angioedema (63.8%). Although anaphylaxis was frequently observed, epinephrine administration was disproportionately low.

Conclusion: A thorough evaluation of suspected DHRs is essential. Despite high suspicion rates, confirmation via diagnostic tests was low, emphasizing the need for referral to specialized clinics and appropriate diagnostics for accurate management. When full diagnostic work-up is not feasible, safe drug testing should at least be done, and patients should not be left without treatment.