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β-Lactam Allergy in Children
Ayse Suleyman1, Ahmet İlhan Yararli2, Esra Yucel1
1Department of Pediatrics, Division of Pediatric Allergy and Immunology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
Most children with suspected beta-lactam antibiotic allergy can tolerate the drugs, as confirmed by skin and drug provocation tests. Older age and early reactions are risk factors for confirmed allergies, with a small chance of cross-reactivity between penicillin and cephalosporins.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Pharmacology
- Drug Hypersensitivity
Background:
- Beta-lactam antibiotic allergy is common in children, but many suspected cases are not true allergies.
- Accurate diagnosis is crucial for appropriate antibiotic selection and management.
Purpose of the Study:
- To assess clinical and laboratory features of pediatric beta-lactam allergy.
- To determine cross-reactivity between penicillin and cephalosporins in children.
Main Methods:
- Diagnosis of beta-lactam allergy was based on skin tests and/or drug provocation tests (DPT).
- Evaluated reactions to penicillin, ampicillin/amoxicillin, and culprit cephalosporins.
Main Results:
- 87.7% of children tolerated the suspected culprit beta-lactam drug.
- Among confirmed allergies, 2/10 showed cross-reactivity between penicillin and cephalosporins.
- Older age and early-type reactions were risk factors for confirmed beta-lactam allergy.
Conclusions:
- Skin tests and DPT are valuable for diagnosing beta-lactam allergy and identifying safe alternatives.
- The majority of children tolerated the drug, indicating low rates of true allergy.
- A small subset with confirmed allergy may need to avoid all beta-lactams due to cross-reactivity risk.
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