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Prevalence of Hypersensitivity Reactions in Children Associated with Acetaminophen: A Systematic Review and
Insights
Hypersensitivity reactions to acetaminophen, a common fever reducer, occur in over 25% of cases. In children with suspected allergy, acetaminophen hypersensitivity prevalence was 10.1% via oral challenge.
Area of Science:
- Pediatric Allergy and Immunology
- Pharmacovigilance
- Drug Hypersensitivity
Background:
- Acetaminophen is a widely used antipyretic in pediatric populations.
- Limited data exist regarding hypersensitivity reactions to acetaminophen.
Observation:
- A systematic review of 85 studies (1,030 participants) characterized acetaminophen reactions.
- Immediate reactions occurred in >25%, nonimmediate cutaneous reactions in ~25%.
- Severe reactions like SJS/TEN and fixed drug eruptions were also reported.
Findings:
- A meta-analysis of 5 pediatric studies found a 10.1% prevalence of acetaminophen hypersensitivity in children undergoing oral challenge.
- This highlights a significant, though not fully quantified, risk in this population.
Implications:
- Further research is needed to assess immediate and nonimmediate acetaminophen hypersensitivity risks.
- Elucidating the mechanisms of acetaminophen hypersensitivity is crucial for improved patient safety.
Background:
Acetaminophen is the most commonly used antipyretic in children. However, there are limited data assessing hypersensitivity reactions related to acetaminophen usage.
Objectives:
To conduct a systematic review to characterize reported reactions to acetaminophen in adults and children, and perform a meta-analysis to assess the prevalence of acetaminophen hypersensitivity in children with a suspected acetaminophen allergy.
Methods:
We performed a systematic review of studies reporting hypersensitivity reactions to acetaminophen by searching 2 electronic databases. From the selected studies, we included those assessing the prevalence of acetaminophen hypersensitivity by performing oral challenge in our meta-analysis.
Results:
Eighty-five studies were included in the systematic review, assessing a total of 1,030 participants. Immediate (within 1 h of exposure) hypersensitivity reactions were reported in > 25% of the articles, while cutaneous nonimmediate reactions were similarly reported in about 25% of the articles. The remaining articles reported Steven-Johnson syndrome/toxic epidermal necrolysis, fixed drug eruptions, and cross-intolerance reactions. Five pediatric studies were included in our meta-analysis. The prevalence of acetaminophen hypersensitivity reaction among children undergoing oral challenge was 10.1% (95% confidence interval 4.5-15.5).
Conclusion:
Future studies assessing the risk of immediate and nonimmediate hypersensitivity reactions to acetaminophen and elucidating the mechanism of acetaminophen hypersensitivity reactions are required.
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