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Related Experiment Videos

Aminopenicillin allergy

A Romano1, D Quaratino, G Papa

  • 1Institute of Internal and Geristric Medicine, Catholic University of St Cuore, Rome, Italy.

Archives of Disease in Childhood
|June 1, 1997
PubMed
Summary
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Aminopenicillin treatment can cause rashes in children. Hypersensitivity reactions, both immediate and delayed, were diagnosed in 9.8% of children, with specific diagnostic methods recommended for each type.

Area of Science:

  • Pediatric Allergy and Immunology
  • Dermatology
  • Pharmacology

Background:

  • Aminopenicillins are commonly prescribed antibiotics.
  • Cutaneous rashes are a known adverse effect of aminopenicillin treatment in children.
  • Distinguishing between immediate and delayed hypersensitivity reactions is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the incidence and diagnostic methods for hypersensitivity reactions to aminopenicillins in children presenting with maculopapular or urticarial rashes.
  • To differentiate between immediate (IgE-mediated) and delayed (cell-mediated) hypersensitivity mechanisms.

Main Methods:

  • Skin tests, patch tests, radioallergosorbent assays (RAST), and oral challenges were performed in children with a history of rashes during aminopenicillin treatment.

Related Experiment Videos

  • Allergologic findings were correlated with clinical presentation (maculopapular vs. urticarial rashes).

    • Main Results:

    • Hypersensitivity was diagnosed in 9.8% of children (4 immediate, 4 delayed).
    • Maculopapular rashes were associated with delayed hypersensitivity, diagnosable via late intradermal reactions and/or patch tests.
    • Urticarial reactions were typically immediate hypersensitivity, often reacting to penicilloyl polylysine and minor determinant mixture.
    • Negative findings were confirmed in 49 children via oral challenges.

    Conclusions:

    • Maculopapular rashes in children treated with aminopenicillins may indicate delayed hypersensitivity.
    • Diagnostic approaches should include specific testing for the suspected aminopenicillin and its side chain.
    • Urticarial rashes suggest immediate hypersensitivity, requiring different diagnostic considerations.
    • The timing of testing relative to antigen exposure is important for interpreting results, especially for IgE-mediated reactions.