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Beta-lactam allergy in the paediatric population.
Tiffany Wong1, Adelle Atkinson1, Geert t'Jong1
1Canadian Paediatric Society, Allergy Section, Ottawa, Ontario.
Paediatrics & Child Health
|February 12, 2020
Summary
Most children diagnosed with beta-lactam allergy can safely tolerate these antibiotics after allergy evaluation. Accurate diagnosis avoids negative outcomes like increased infections and costs, ensuring appropriate antibiotic use.
Area of Science:
- Pediatric Allergy and Immunology
- Infectious Diseases
- Clinical Pharmacology
Background:
- Beta-lactam allergy is frequently diagnosed in children, yet most are not truly allergic.
- Unnecessary beta-lactam allergy labels lead to adverse outcomes, including broader antibiotic use and increased healthcare costs.
Purpose of the Study:
- To provide guidance on risk stratification for beta-lactam allergy in pediatric patients.
- To outline appropriate testing and management strategies for children with suspected beta-lactam allergy.
Main Methods:
- Review of current literature and clinical guidelines on beta-lactam allergy diagnosis and management.
- Development of a risk stratification approach for pediatric patients.
- Recommendations for outpatient testing, monitoring, and specialist referral.
Main Results:
- Over 90% of children with reported beta-lactam allergy tolerate the drugs upon allergist evaluation.
- Avoiding cephalosporins is unnecessary for most children with penicillin allergies.
- Specific severe cutaneous adverse reactions (e.g., SJS, DRESS, AGEP) require careful consideration.
Conclusions:
- Accurate diagnosis and risk stratification are crucial to de-label unnecessary beta-lactam allergies in children.
- Appropriate management can prevent negative clinical outcomes and reduce antibiotic resistance.
- Guidance supports safe testing and appropriate referral for pediatric beta-lactam allergy.
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