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Hypersensitivity to clavulanic acid in children

M Tortajada Girbés1, A Ferrer Franco, M Gracia Antequera

  • 1Paediatric Allergy Section. Department of Paediatrics. University of Valencia. Spain. tortajadamig@gmail.com

Allergologia Et Immunopathologia
|December 17, 2008
PubMed

Insights

Children allergic to amoxicillin/clavulanic acid (A-CL) experienced urticaria and angio-oedema. These patients tolerated cefuroxime axetil, indicating a safe alternative for treating infections in penicillin-allergic children.

Area of Science:

  • Pediatric Allergy and Immunology
  • Clinical Pharmacology
  • Infectious Diseases

Background:

  • Amoxicillin/clavulanic acid (A-CL) is frequently prescribed for pediatric infections.
  • Adverse reactions, including IgE-mediated allergy to clavulanic acid (CL), can occur.
  • Accurate diagnosis and identification of safe antibiotic alternatives are crucial for managing these allergies.

Purpose of the Study:

  • To investigate the clinical presentation and diagnostic confirmation of clavulanic acid allergy in children.
  • To evaluate the safety and tolerance of cefuroxime axetil in children with confirmed clavulanic acid allergy.

Main Methods:

  • Retrospective case series of 10 children (aged 4-12 years) diagnosed with clavulanic acid allergy.
  • Diagnosis confirmed by IgE-mediated allergy via oral challenge test with amoxicillin-clavulanic acid.
  • Skin prick tests and specific IgE levels for common penicillins and cephalosporins were performed.

Main Results:

  • All 10 children presented with urticaria and angio-oedema following A-CL administration.
  • Oral challenge confirmed IgE-mediated allergy to clavulanic acid in all cases.
  • All patients demonstrated tolerance to orally administered cefuroxime axetil.

Conclusions:

  • Clavulanic acid allergy can manifest as urticaria and angio-oedema in children.
  • Oral challenge testing is a reliable method for diagnosing clavulanic acid allergy.
  • Cefuroxime axetil appears to be a safe and well-tolerated oral alternative for children with confirmed clavulanic acid allergy.

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