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[Allergy to beta-lactam antibiotics in childhood. Diagnostic problems]
A Venuti1, A Romano, D Pocobelli
1Istituto Clinica Medica, U.C.S.C., Roma, Italia.
Insights
This study investigated penicillin allergy in children, finding that early allergy testing is crucial as results can change rapidly. Prompt diagnosis aids in identifying true beta-lactam allergy.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Immunology
- Pharmacology
Context:
- Adverse drug reactions, particularly to beta-lactam antibiotics, are a significant concern in pediatric populations.
- Accurate diagnosis of hypersensitivity is essential for appropriate antibiotic selection and patient management.
- Understanding the prevalence and patterns of beta-lactam allergy in children informs clinical practice.
Purpose:
- To evaluate the prevalence of hypersensitivity reactions to beta-lactam antibiotics in children.
- To identify common causative agents and clinical manifestations of these reactions.
- To assess the utility and timing of diagnostic allergy testing in pediatric patients.
Summary:
- The study analyzed 126 children (aged 1-12 years) with suspected hypersensitivity to beta-lactam antibiotics, with a majority being males aged 7-12 years.
- Cutaneous reactions were the most common manifestation (87.3%). Semisynthetic penicillin was the most frequent culprit (44.6%), followed by cephalosporins and penicillin.
- Allergy testing, including skin tests and RAST, revealed a 5.8% allergy rate. The study emphasizes testing within 6 months of reaction onset due to potential loss of sensitivity.
Impact:
- Highlights the importance of timely allergy evaluations in children to confirm beta-lactam hypersensitivity.
- Suggests that early testing can improve diagnostic accuracy and guide safer antibiotic prescribing.
- Provides data on the prevalence and types of beta-lactam allergy in a pediatric cohort, aiding future research and clinical guidelines.
Abstract:
This study reports about 126 children with an age ranging from 12 months to 12 years having RA to beta-lactamase. More children with an age ranging from 7-12 years (59.5%), and more male (65.9%) than female subjects were studied. 76 patients (60.3%) showed a familial anamnesis of allergic diseases or similar diseases and a personal anamnesis of allergic diseases (45.2%). Among the RA responsible substances the more frequent were semisynthetic penicillin (44.6%) followed by cephalosporin and penicillin. Most clinical manifestations (87.3%) were cutaneous reactions and in smaller number of cases it was possible to observe gastroenteric or respiratory reactions. In 121 patients cutaneous tests were undertaken (Prick tests and intradermoreactions), patch tests, employing: PPL, MDM, Penicillin, Ampicillin, Cephaloridine. 5.8% of the studied subjects showed an allergy. Particularly 2.4% showed a "early" positivity. RAST was carried out in 92 patients and 3 of them showed a positive result (3.2%). This study stresses the opportunity to carry out allergologic tests within 6 months since the beginning of RA. In fact especially in children this test result can soon become negative. Furthermore the reduced percentage of positive allergologic tests can be due to the inclusion in other studies of patients with "coincidental reactions". A certain number of RA can be caused by additive to "per os" products. Finally it will be possible to use "tests dose" even in selectioned cases. These tests can frequently exclude the etiopathogenetic responsibility of beta-lactamic substances.