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Tolerability of meropenem in children with IgE-mediated hypersensitivity to penicillins

M Atanasković-Marković1, F Gaeta, B Medjo

  • 1Department of Allergology and Pulmonology, University Children's Hospital, Belgrade, Serbia.

Allergy
|January 12, 2008
PubMed
Abstract

Insights

Meropenem is safe for most children with penicillin allergies, showing low cross-reactivity. Skin testing before meropenem (a carbapenem antibiotic) is recommended for children requiring this treatment.

Area of Science:

  • Clinical Immunology
  • Infectious Diseases
  • Pediatric Allergy

Background:

  • Previous studies suggested high meropenem cross-reactivity in penicillin-allergic patients, leading to treatment avoidance.
  • Recent adult studies indicated low cross-reactivity between penicillins and carbapenem antibiotics like meropenem.
  • This study addresses the need to clarify meropenem safety in pediatric penicillin allergy.

Purpose of the Study:

  • To evaluate the cross-reactivity and tolerability of meropenem in children with a history of penicillin allergy.
  • To determine if meropenem can be safely administered to pediatric patients with documented penicillin hypersensitivity.

Main Methods:

  • 108 children with immediate penicillin reactions and positive skin tests underwent skin testing with meropenem.
  • Children with negative meropenem skin tests were subsequently challenged with the antibiotic.
  • Skin tests and challenges were used to assess immediate hypersensitivity reactions.

Main Results:

  • Only one child (0.9%) showed a positive skin test reaction to meropenem.
  • The remaining 107 children with negative skin tests tolerated meropenem challenges.
  • No full therapeutic courses were administered following the challenges.

Conclusions:

  • Meropenem exhibits a low rate of cross-reactivity in children with penicillin allergy.
  • Avoiding meropenem in children with immunoglobulin E-mediated hypersensitivity may no longer be necessary.
  • Prophylactic skin testing for meropenem is advisable in pediatric patients requiring this antibiotic, as negative tests indicate tolerability.

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