[Investigation for penicillin allergy among children]
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1Odense Sygehus, paediatrisk afdeling.
Insights
Penicillin allergy testing in children can be simplified. Meticulous history taking and oral penicillin provocation are recommended over extensive allergy tests for accurate penicillin allergy diagnosis.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Immunology
- Pharmacology
Context:
- Investigating penicillin allergy in children is crucial for safe and effective treatment.
- Previous diagnostic methods for penicillin allergy were resource-intensive.
- A study was conducted between 1986-1991 involving 109 children.
Purpose:
- To evaluate the efficacy of different diagnostic methods for penicillin allergy in pediatric patients.
- To determine the most reliable and practical approach for diagnosing penicillin allergy in children.
Summary:
- Specific IgE to penicillin (SIgEP) and prick tests were performed. Children negative on these tests underwent oral penicillin provocation.
- Only two children tested positive for SIgEP; one tolerated penicillin treatment.
- One child developed a delayed urticarial rash after oral provocation, highlighting the need for careful monitoring.
Impact:
- The findings suggest that a combination of detailed patient history and oral penicillin challenge is sufficient for diagnosing penicillin allergy in children.
- This approach can reduce the need for complex laboratory tests, making diagnosis more accessible.
- It emphasizes the importance of having anaphylaxis treatment readily available during oral provocation tests.
Abstract:
During the period 1986-1991, 109 children were tested for penicillin allergy in the paediatric departments of Odense and Roskilde Hospitals. Determinations of specific IgE to penicillin (SIgEP) were performed on all of the children. Prick tests for penicillin were undertaken in the children i Odense only. All of the children who reacted negatively to SIgEP and the prick test were provoked by oral penicillin. Two children were SIgEP positive. One of these children was subsequently treated with penicillin without reaction. All of the prick tests were negative. One child reacted with an urticarial rash five hours after oral provocation. It is recommended that investigation for allergy to penicillin in children should be restricted to meticulous history taking and oral provocation with penicillin with equipment for treatment of anaphylaxis in readiness.