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10.1111/pai.12565

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suck abstract from ncbi


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pmid26999792
      Pediatr+Allergy+Immunol 2016 ; 27 (5 ): 533-8
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  • Non-immediate hypersensitivity reactions to beta-lactam antibiotics in children - our 10-year experience in allergy work-up #MMPMID26999792
  • Atanaskovic-Markovic M ; Gaeta F ; Medjo B ; Gavrovic-Jankulovic M ; Cirkovic Velickovic T ; Tmusic V ; Romano A
  • Pediatr Allergy Immunol 2016[Aug]; 27 (5 ): 533-8 PMID26999792 show ga
  • BACKGROUND: Non-immediate reactions to beta-lactam antibiotics (BL) occur more than one hour after drug administration, and the most common manifestations are maculopapular exanthemas and delayed-appearing urticaria and/or angioedema. Infections can lead to skin eruptions and mimic drug hypersensitivity reactions (DHR), if a drug is taken at the same time. The most of children are labeled as 'drug allergic' after considering only the clinical history. OBJECTIVE: To diagnose/detect a hypersensitivity or an infection which mimic DHR in children with non-immediate reactions to BL METHODS: A prospective survey was conducted in a group of 1026 children with histories of non-immediate reactions to BL by performing patch tests, skin tests, and in case of negative results, drug provocation tests (DPTs). In 300 children, a study was performed to detect infections by viruses or Mycoplasma pneumoniae. RESULTS: Urticaria and maculopapular exanthemas were the most reported non-immediate reactions. Only 76 (7.4%) of 1026 children had confirmed non-immediate hypersensitivity reactions to BL. Fifty-seven children had positive delayed-reading intradermal tests (18 of these with a positive patch test). Nineteen children had positive DPT. Sixty-six of 300 children had positive tests for viruses or Mycoplasma pneumoniae and 2 of them had a positive allergy work-up. CONCLUSIONS: A diagnostic work-up should be performed in all children with non-immediate reactions to BL, to remove a false label of hypersensitivity. Even though only 57 (5.5%) of 1026 children displayed positive responses to delayed-reading intradermal tests to BL, such tests appear to be useful in order to reduce the risk for positive DPTs.
  • |Adolescent [MESH]
  • |Allergens/immunology [MESH]
  • |Child [MESH]
  • |Child, Preschool [MESH]
  • |Diagnosis, Differential [MESH]
  • |Exanthema/*diagnosis [MESH]
  • |Female [MESH]
  • |Humans [MESH]
  • |Hypersensitivity, Delayed/*diagnosis [MESH]
  • |Infant [MESH]
  • |Male [MESH]
  • |Mycoplasma pneumoniae/*physiology [MESH]
  • |Pneumonia, Mycoplasma/*diagnosis [MESH]
  • |Prospective Studies [MESH]
  • |Skin Tests [MESH]
  • |Urticaria/*diagnosis [MESH]
  • |Virus Diseases/*diagnosis [MESH]


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