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Diagnostic evaluation of hypersensitivity reactions to beta‐lactam antibiotics in a large population of children
Author(s) -
Zambonino Maria A.,
Corzo Jose Luis,
Muñoz Candelaria,
Requena Gloria,
Ariza Adriana,
Mayorga Cristobalina,
Urda Antonio,
Blanca Miguel,
Torres M. J.
Publication year - 2014
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12155
Subject(s) - medicine , provocation test , dermatology , cefaclor , culprit , erythema , amoxicillin , allergy , drug allergy , sensitization , antibiotics , penicillin , cefixime , population , cetirizine , levocetirizine , anaphylaxis , hypersensitivity reaction , patch test , cephalosporin , anesthesia , immunology , pathology , pharmacology , biology , alternative medicine , environmental health , myocardial infarction , microbiology and biotechnology
Hypersensitivity reactions to beta‐lactams ( BL s) are often reported in children, with amoxicillin and, to a lesser extent, cephalosporins being the most frequent drugs involved. Although many of these children are considered to be allergic, a careful evaluation only confirms a low percentage. Objectives To analyse the clinical data, sensitization profile and diagnostic methods used in a large group of children with a clinical history of hypersensitivity reactions to BL s. Methods The study included children aged 1–14 yr with symptoms suggestive of hypersensitivity to BL s from January 2006–December 2012. Diagnosis was confirmed from a clinical history, specific I g E determination, skin testing and, if necessary, a drug provocation test ( DPT ). Results Of a total of 783 patients studied, only 62 (7.92%) were confirmed as being allergic, 9 (14.52%) with immediate and 53 (85.48%) with non‐immediate reactions. In those with immediate reactions, 2 (22.22%) were diagnosed by in vitro test, 2 (22.22%) by skin testing and 5 (55.56%) by DPT ; in those with non‐immediate reactions, 2 (3.77%) were diagnosed by skin testing and 51 (96.23%) by DPT . In all cases, DPT was positive to the culprit drug (29 AX ‐ CLV , 26 AX , 1 cefixime and 1 cefaclor), and the most usual symptoms were exanthema in 43 cases, urticaria in 12, urticaria–angio‐oedema in 1 and erythema in 1 case. Conclusion After an allergological work‐up, over 90% of the children evaluated were finally confirmed as tolerant to BL s. Most reactions were of the non‐immediate type, and DPT was an essential tool for diagnosis.