Related Experiment Video

Updated: Jun 3, 2026

A Suction Blister Protocol to Study Human T-cell Recall Responses In Vivo
11:17

A Suction Blister Protocol to Study Human T-cell Recall Responses In Vivo

Published on: August 11, 2018

The prevalence of antibiotic skin test reactivity in a pediatric population

Sonia Kamboj1, Ejaz Yousef, Stephen McGeady

  • 1Department of Allergy and Immunology, Alfred I. duPont Hospital for Children, Wilmington, Delaware 19803, USA.

Allergy and Asthma Proceedings
|March 29, 2011
PubMed

Insights

Most children with reported antibiotic allergies do not have true immunologic reactions. Provocative drug challenges in pediatric patients show that over 90% can safely receive antibiotics, avoiding unnecessary avoidance.

Area of Science:

  • Pediatric Allergy and Immunology
  • Pharmacovigilance
  • Clinical Pharmacology

Background:

  • Adverse drug reactions (ADRs) are common, but true allergic reactions are rare.
  • Most studies on penicillin (PCN) allergy are in adults, suggesting many can safely receive PCN.
  • Pediatric antibiotic allergy data is limited, leading to potential overuse of alternative antibiotics.

Purpose of the Study:

  • To evaluate outcomes of antibiotic provocative drug challenges in children with a history of ADR.
  • To correlate challenge outcomes with predictive factors for true antibiotic allergy.
  • To reduce unnecessary antibiotic avoidance in pediatric patients.

Main Methods:

  • Retrospective chart review of 96 pediatric patients with antibiotic ADR history.
  • Inclusion of skin testing (ST) and/or graded challenges to penicillin, cephalosporins, azithromycin (AZT), or clindamycin.
  • Analysis of outcomes based on positive ST or failed challenge events.

Main Results:

  • 90.6% of pediatric patients (87/96) tolerated provocative antibiotic challenges.
  • Only 9.4% (9/96) had positive ST or failed challenges, indicating true allergy.
  • Penicillin allergy was confirmed in 8 of the 9 patients with positive results.

Conclusions:

  • True antibiotic allergy in children with a history of ADR is uncommon (<10%).
  • Provocative drug challenges are valuable in identifying children who can safely receive antibiotics.
  • Unnecessary avoidance of first-line antibiotics can be prevented through appropriate allergy testing.

More Related Videos

Basophil Activation Test for Allergy Diagnosis07:22

Basophil Activation Test for Allergy Diagnosis

Published on: May 31, 2021

A Component-resolved Diagnostic Approach for a Study on Grass Pollen Allergens in Chinese Southerners with Allergic Rhinitis and/or Asthma06:34

A Component-resolved Diagnostic Approach for a Study on Grass Pollen Allergens in Chinese Southerners with Allergic Rhinitis and/or Asthma

Published on: June 4, 2017

Related Concept Videos

Allergic Reactions02:06

Allergic Reactions

Overview
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Allergic Reactions: Anaphylaxis01:30

Allergic Reactions: Anaphylaxis

Anaphylaxis is a severe, life-threatening hypersensitivity reaction mediated by Immunoglobulin E (IgE) antibodies. When IgE binds to allergens, it triggers the release of mediators– histamine, leukotrienes, and prostaglandins from mast cells and basophils. These mediators cause vasodilation, edema, and inflammation, leading to various symptoms.The primary allergens causing anaphylaxis include food items (e.g., peanuts, shellfish), drugs (e.g., penicillin, asparaginase, corticotropin, heparin),...
Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial exposure to a...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...