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Hypersensitivity reactions to non-betalactam antibiotics in children: an extensive review

Semanur Kuyucu1, Francesca Mori, Marina Atanaskovic-Markovic

  • 1Department of Pediatric Allergy and Immunology, Mersin University, Faculty of Medicine, Mersin, Turkey.

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|September 10, 2014
PubMed

Insights

Hypersensitivity reactions (HSRs) to non-β-lactam antibiotics (NBLAs) in children are poorly understood, with limited diagnostic tools. Standardized approaches are needed for evaluating these critical reactions.

Area of Science:

  • Pediatric Allergy and Immunology
  • Pharmacology and Therapeutics

Background:

  • Hypersensitivity reactions (HSRs) to non-β-lactam antibiotics (NBLAs) in children are under-researched, with data primarily from case reports.
  • NBLAs can cause a broad range of HSRs, from mild rashes to severe, potentially fatal systemic reactions, particularly in high-risk pediatric populations.

Purpose of the Study:

  • To review and synthesize current knowledge on the clinical characteristics, diagnostic evaluation, and management of HSRs to NBLAs in children.
  • To highlight the challenges in diagnosing NBLA hypersensitivity due to limitations in current testing methodologies.

Main Methods:

  • Extensive literature review of studies published between 1980 and 2013.
  • Analysis of clinical characteristics, diagnostic approaches (history, skin tests, provocation tests), and management strategies for NBLA-induced HSRs in pediatric patients.

Main Results:

  • Diagnosis of NBLA-induced HSRs heavily relies on patient history, as allergological tests often remain unconfirmed.
  • Validated in vivo and in vitro diagnostic tests for NBLAs are lacking, making definitive diagnosis challenging.
  • Confirmed HSRs to NBLAs in children ranged from 7.8% to 36% when assessed by skin and/or provocation tests.

Conclusions:

  • A significant proportion of suspected HSRs to NBLAs in children are not confirmed by objective testing.
  • There is a critical need for standardized diagnostic approaches and management strategies for pediatric patients experiencing suspected HSRs to NBLAs.
  • Developing such strategies is essential, especially given the importance of some NBLAs in pediatric treatment regimens.

Keywords:
childrendiagnosisdrug allergydrug hypersensitivitynon-beta(β)lactam antibioticsskin tests

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