Related Experiment Video
Updated: Feb 5, 2026
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Drug-Induced Anaphylaxis in Children: A Comparative Analysis of Inpatient versus Outpatient Settings
Gizem Koken1, Hacer Ilbilge Ertoy Karagol2, Sinem Polat Terece1
1Department of Pediatric Allergy and Immunology, Gazi University Faculty of Medicine, Ankara, Turkey.
Insights
Pediatric drug-induced anaphylaxis (DIA) characteristics varied by inpatient vs. outpatient settings. While onset and severity were similar, triggering drugs and comorbidities differed, influenced by parenteral drug administration frequency.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Pharmacology
- Emergency Medicine
Background:
- Drug-induced anaphylaxis (DIA) in children is understudied.
- No prior studies have compared inpatient (IP) and outpatient (OP) settings for pediatric DIA.
- This study addresses the gap by comparing pediatric DIA characteristics across IP and OP environments.
Purpose of the Study:
- To compare the characteristics of pediatric drug-induced anaphylaxis (DIA) in inpatient versus outpatient settings.
- To identify differences in triggering agents, comorbidities, and management between IP and OP pediatric DIA cases.
- To analyze factors influencing the presentation and severity of DIA based on the care setting.
Main Methods:
- Retrospective review of 162 pediatric DIA cases (patients ≤18 years) over 15 years.
- Categorization into inpatient (IP) and outpatient (OP) groups based on the setting of DIA occurrence.
- Clinical diagnosis of DIA, with diagnostic testing for eligible patients.
Main Results:
- Chemotherapeutics, enzyme replacement therapies, and antibiotics were common IP triggers; NSAIDs, antibiotics, and local anesthetics were common OP triggers.
- Parenteral drug administration was more frequent in the IP group.
- Despite similar onset and severity initially, differences emerged when parenteral drugs were excluded from OP analysis; comorbidities and co-factors varied significantly between IP and OP groups.
Conclusions:
- Pediatric DIA exhibits distinct triggering drugs, comorbidities, and co-factors depending on whether it occurs in inpatient or outpatient settings.
- The care setting did not significantly impact the onset or severity of DIA, potentially due to the higher incidence of parenteral drug administration in OP settings.
- Findings highlight the importance of considering setting-specific factors in the diagnosis and management of pediatric DIA.
Introduction:
Studies specifically focusing on drug-induced anaphylaxis (DIA) in children are few. There is no study comparing inpatient (IP) and outpatient (OP) settings in DIA, either in children or in adults. We aimed to compare the characteristics of pediatric DIAs observed in IP and OP settings.
Methods:
Patients aged ≤18 years who were diagnosed with DIA at our institution over the past 15 years were included in the study. The diagnosis of DIA was made clinically, and diagnostic testing was performed in eligible patients. Patients were categorized as IP and OP groups based on the settings in which DIA occurred.
Results:
A total of 162 pediatric DIAs (55% IP vs. 45% OP) were reviewed. The most frequent triggering drugs were chemotherapeutics, enzyme replacement therapies for metabolic disorders, and antibiotics in IP group, and NSAIDs, antibiotics, and local anesthetics in OP group. Parenteral drug use was more frequent in IP group (p < 0.001). Age at DIA, time to DIA, and severity of DIA were similar between the two groups. However, after excluding parenteral drugs from OP group, significant differences in all three parameters were seen in IP group (p < 0.05 for each). Patients in IP group had more nonallergic chronic comorbidities and gastrointestinal symptoms, while OP group showed higher rates of asthma, allergic rhinitis, and acute infections as cofactors (p ≤ 0.001 for each). Antihistamine and systemic corticosteroid use were higher in OP group (p < 0.05 for each), but the use of intramuscular adrenaline was similar in both groups.
Conclusion:
Triggering drugs, clinical presentations, management, chronic allergic and nonallergic comorbidities, and cofactors in pediatric DIA differ between the two groups. Contrary to expectations, the setting did not affect the onset or severity of DIA, likely due to the higher frequency of parenteral drug administration in OP settings.
Related Concept Videos
01:29Drug Dosing: Infants and Children
01:20Comparing the Survival Analysis of Two or More Groups
01:26Therapeutic Drug Monitoring: Drug Analysis Methods
02:26Comparing Copy Number Variations and SNPs
Copy number variations or CNVs are the structural variations that cover more than 1kb of DNA sequence. The single nucleotide polymorphism (SNP), on the other hand, is a single nucleotide change or a point mutation that is found in more than 1%...
01:12Setting Time of Cement
01:35Pedigree Analysis