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Penicillin sensitivity among children without a positive history for penicillin allergy

Feyzullah Cetinkaya1, Yakup Cag

  • 1Department of Pediatrics, Sisli Etfal Education and Research Hospital, Istanbul, Turkey. feyzulkaya@mynet.com

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|June 24, 2004
PubMed

Insights

Frequent penicillin use in children can lead to sensitization, as indicated by positive skin tests. This study found 10.2% of children without prior reactions showed sensitization to penicillin antigens.

Area of Science:

  • Allergy and Immunology
  • Pediatric Infectious Diseases
  • Pharmacology

Background:

  • Penicillin is a widely used antibiotic, particularly in pediatric populations.
  • Previous allergic reactions are typically a contraindication for penicillin use.
  • The prevalence of penicillin sensitization in asymptomatic children with frequent exposure is not well-established.

Purpose of the Study:

  • To determine the prevalence of positive penicillin skin tests in children with no history of allergic reactions.
  • To investigate the potential for sensitization following repeated penicillin exposure in children.
  • To assess the safety and efficacy of penicillin skin testing in this population.

Main Methods:

  • A cohort of 147 children (aged 6-13 years) with at least three penicillin administrations in the past year and no prior allergic reactions were enrolled.
  • Detailed pediatric and allergy histories were obtained for all participants.
  • Skin testing was performed using benzyl penicilloyl polylysin (PPL) and a mixture of minor antigenic determinants, employing both epidermal and intradermal routes.

Main Results:

  • The overall frequency of positive skin reactions to penicillin antigens was 10.2%.
  • One child experienced a mild systemic reaction during testing with PPL.
  • A significant proportion of children showed evidence of sensitization despite asymptomatic exposure history.

Conclusions:

  • Frequent exposure to penicillin and other beta-lactam antibiotics can lead to sensitization in children, even without a history of overt allergic reactions.
  • Penicillin skin testing can identify asymptomatic sensitization in pediatric populations.
  • These findings highlight the need for careful consideration of antibiotic use and potential sensitization in children.

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