Therefore, anaphylactic reactions must be especially appreciated in their study. However, the attainment of various organs or systems can make the reaction potentially fatal. Skin is the organ most frequently involved in hypersensitivity reactions to BL. 4 If there were no reaction in the DPT, studies evaluating the validity of the DPT show that the majority of patients (>95%) tolerate the drug in real life. 8 Although the sensitivity and specificity of cutaneous tests, some studies show that more than 30% of patients with allergic reactions to BL will fail the diagnosis if they do not undergo a DPT. 7 If there was a suggestive history of DH with negative or non-conclusive tests we performed a drug provocation test (DPT), considered mandatory for DH diagnosis. 6 In case of BL we can perform skin prick and intradermal tests and in vitro tests with an assay of specific IgE. 5 In the pediatric age, studies are even scarcer.įor most of the drug hypersensitivity (DH) reactions, no sensitization can be showed. 3 The prevalence and incidence of allergic reactions to BL in the population are not well known, 4 with reports from 0.7 to 10%, with anaphylaxis from 0.004% to 0.015%. 2 Furthermore, anaphylaxis from drug intake has grown in the last two decades. 1 The increasing use of antibiotics, overmedication along the time, and the synthesis of new drugs enhance the risk of new allergic reactions. ConclusionsĪllergic reactions to beta-lactams, although rare in children, require a detailed clinical history and a specialized drug allergy work-up to allow a correct diagnosis as well as to avoid the possibility of a potential life-threatening reaction and provide alternative drugs.īeta-lactams antibiotics (BL) are the most frequent elicitors of allergic drug reactions in children. Almost all cases of confirmed anaphylaxis (six from seven cases) were IgE mediated, with positive skin tests despite negative serum specific-IgE. In this sample, we also performed oral challenge with cefuroxime, being negative in all cases. The culprit drug was amoxicillin in six and flucloxacillin in one. In seven children (33.3% of those with confirmed beta-lactams hypersensitivity) anaphylaxis was confirmed, and all of them described reactions with cutaneous and respiratory or gastrointestinal involvement. In all of them, except for three children, an alternative beta-lactam was found. Resultsġ46 children with suspected beta-lactams hypersensitivity were studied, and in 21 (14.4%) the diagnosis was confirmed. Description of the drug allergy work-up performed studied according to standardized diagnostic procedures of ENDA/EAACI, including specific-IgE assay, skin prick and intradermal tests and diagnostic/alternative drug challenge tests. Retrospective analysis of all children referred to our Drug Allergy Center with suspected beta-lactams hypersensitivity between January 2011 and December 2016. ObjectiveĬharacterization of case reports of anaphylaxis in children referred to an allergy department with suspected beta-lactams hypersensitivity. Anaphylactic reactions may occur and need to be properly studied, but studies in children are scarce. Ver másīeta-lactams are the most frequently used antibiotics in pediatric age. Letters to the Editor on previously published papers are welcomed.Allergologia et Immunopathologia publishes 6 issues per year and is included in the major databases such as Pubmed, Scopus, Web of Knowledge, etc. Occasionally, the opinion of an expert on a burning topic is published in the "Point of View" The journal accepts original and review articles from all over the world, together with consensus statements from the aforementioned societies. It has and independent international Editorial Committee which submits received papers for peer-reviewing by international experts. Allergologia et Immunopathologia is the official journal of the Spanish Society of Pediatric Allergy and Clinical Immunology. Manuscripts related to clinical, epidemiological and experimental allergology and childhood immunopathology will be considered for publication. Allergologia et Immunopathologia is no longer published on Elsevier since the 2021 year.Transferred to Codon PublicationsĪllergologia et Immunopathologia is a forum for those working in the field of asthma, allergy and immunology related to childhood.
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