β-Lactam Allergy in Children.


Suleyman A., Yararli A. İ., Yucel E., Tamay Z., Guler N.

Sisli Etfal Hastanesi tip bulteni, cilt.55, sa.3, ss.374-381, 2021 (ESCI, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 55 Sayı: 3
  • Basım Tarihi: 2021
  • Doi Numarası: 10.14744/semb.2021.24434
  • Dergi Adı: Sisli Etfal Hastanesi tip bulteni
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.374-381
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Hayır

Özet

Objective: beta-lactam antibiotic allergy is the most common drug allergy in children. Most of the patients with suspected reactions to beta-lactam antibiotics can actually tolerate these drugs. The aim of this study is to evaluate clinical and laboratory characteristics of children with beta-lactam allergy and to determine cross-reactivity between penicillin and cephalosporins. Methods: The diagnosis of beta-lactam allergy was made based on the results of skin tests and/or drug provocation tests (DPT). Penicillin allergy skin tests were performed with DAP penicillin (R) (Diater laboratories, Madrid, Spain), penicillin G, and ampicillin/amoxicillin preparations. Skin and provocation tests were performed with the culprit cephalosporin in addition to the penicillin skin and/or provocation tests to evaluate cephalosporin allergy. Results: We found that 87.7% (71/81) of patients with beta-lactam allergy were able to tolerate the culprit drug. Among ten patients with confirmed diagnosis, two had cross-reactivity (penicillin and cephalosporin) and 8 had a various beta-lactam (aminopenicillin n=6, ceftriaxone n=2) allergies. We identified older age and early-type clinical reactions as risk factors for a confirmed beta-lactam allergy. Conclusion: Skin tests and DPT appear to be useful procedures in the diagnosis, and determination of an alternative safe antibiotic in patients with beta-lactam allergy. Most of the patients tolerated the drugs. A minority of the patients with confirmed allergy should avoid all beta-lactam antibiotics due to the probability of cross-reactivity.