Updates on drug-induced anaphylaxis in children

Area of Science:

• Pediatric Allergy and Immunology
• Clinical Pharmacology
• Emergency Medicine

Background:

• Drug-induced anaphylaxis (DIA) is less common in children but associated with severe reactions.
• Limited data exists on pediatric DIA epidemiology, clinical features, triggers, and management.

Purpose of the Study:

• To review current evidence on pediatric DIA.
• To highlight pediatric-specific aspects of DIA epidemiology, triggers, clinical presentation, and management.

Main Methods:

• Systematic review of existing literature on pediatric drug-induced anaphylaxis.
• Analysis of data on prevalence, causative agents, clinical manifestations, and treatment outcomes.

Main Results:

• Drugs cause up to one-third of childhood anaphylaxis cases, often in healthcare settings.
• Beta-lactams, NSAIDs, anesthetics, and chemotherapeutics are key triggers, with age- and trigger-dependent symptom variations.
• Adrenaline undertreatment is prevalent, emphasizing the need for improved management protocols.

Conclusions:

• DIA significance increases with age; boys are more affected.
• Clinical diagnosis is challenging, especially in young children and perioperative settings.
• Allergy evaluation is essential post-DIA to prevent recurrence and incorrect allergy labeling.