Allergy to beta-lactam antibiotics in children: Risk factors for a positive diagnostic work-up

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Dias de Castro, ED (Author) Other; Carolino, F (Author) Other; Carneiro Leao, L (Author) Other; Barbosa, J (Author) FMUP; Ribeiro, L (Author) Other; Cernadas, JR (Author) Other

Journal

Title: Allergologia et Immunopathologia

Vol. 48

Pages: 417-423

ISSN: 0301-0546

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 4 Citations

Scopus - 4 Citations

Other information

Authenticus ID: P-00S-641

DOI: 10.1016/j.aller.2020.01.005

Abstract (EN): Background: Allergy to beta-lactam (beta L) antibiotics is highly reported in children, but rarely confirmed. Risk factors for a positive diagnostic work-up are scarce. The primary aim was to characterize the cases of children with confirmed beta L allergy, investigating potential risk factors. Secondary aims were to assess the prevalence of allergy to beta L in this population and to confirm the safety of less extensive diagnostic protocols for milder reactions. Methods: We reviewed the clinical data from all children evaluated in our Department for suspected beta L allergy, over a six-year period. Results: Two hundred and twenty children (53% females) with a mean age of 6.5 +/- 4.2 years were evaluated. Cutaneous manifestations were the most frequently reported (96.9%), mainly maculopapular exanthema (MPE). The reactions were non-immediate in 59.5% of the cases. Only 23 children (10.5%) were diagnosed with allergy to beta L. The likelihood of beta L allergy was significantly higher in children with a family history of drug allergy (p< 0.001) and in those with a smaller time period between the reaction and the study (p =0.046). The probability of not confirming beta L allergy is greater in children reporting less severe reactions (p< 0.001) and MPE (p< 0.001). We found the less extensive diagnostic protocol in milder reactions safe, since only 4.2% of the children presented a positive provocation test (similar reaction as the index reaction). Conclusion: This study highlights family history of drug allergy as a risk factor for a positive diagnostic work-up. Larger series are required, particularly genetic studies to accurately determine future risk for beta L allergy in children.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7