Allergy to beta-lactam antibiotics in children: Risk factors for a positive diagnostic work-up
Autores da FMUP
Participantes de fora da FMUP
- de Castro, ED
- Carolino, F
- Carneiro-Leao, L
- Barbosa, J
- Cernadas, JR
Unidades de investigação
Abstract
Background: Allergy to beta-lactam (beta L) antibiotics is highly reported in children, but rarely confirmed. Risk factors for a positive diagnostic work-up are scarce. The primary aim was to characterize the cases of children with confirmed beta L allergy, investigating potential risk factors. Secondary aims were to assess the prevalence of allergy to beta L in this population and to confirm the safety of less extensive diagnostic protocols for milder reactions. Methods: We reviewed the clinical data from all children evaluated in our Department for suspected beta L allergy, over a six-year period. Results: Two hundred and twenty children (53% females) with a mean age of 6.5 +/- 4.2 years were evaluated. Cutaneous manifestations were the most frequently reported (96.9%), mainly maculopapular exanthema (MPE). The reactions were non-immediate in 59.5% of the cases. Only 23 children (10.5%) were diagnosed with allergy to beta L. The likelihood of beta L allergy was significantly higher in children with a family history of drug allergy (p< 0.001) and in those with a smaller time period between the reaction and the study (p =0.046). The probability of not confirming beta L allergy is greater in children reporting less severe reactions (p< 0.001) and MPE (p< 0.001). We found the less extensive diagnostic protocol in milder reactions safe, since only 4.2% of the children presented a positive provocation test (similar reaction as the index reaction). Conclusion: This study highlights family history of drug allergy as a risk factor for a positive diagnostic work-up. Larger series are required, particularly genetic studies to accurately determine future risk for beta L allergy in children. (C) 2020 SEICAP. Published by Elsevier Espana, S.L.U. All rights reserved.
Dados da publicação
- ISSN/ISSNe:
- 1578-1267, 0301-0546
- Tipo:
- Article
- Páginas:
- 417-423
- Link para outro recurso:
- www.scopus.com
Allergologia et Immunopathologia Codon Publications
Citações Recebidas na Web of Science: 6
Citações Recebidas na Scopus: 10
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Filiações
Keywords
- Drug allergy; Beta-lactam antibiotics; Children; Allergy diagnostic work-up; Risk factors
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Citar a publicação
de Castro ED,Carolino F,Carneiro L,Barbosa J,Ribeiro L,Cernadas JR. Allergy to beta-lactam antibiotics in children: Risk factors for a positive diagnostic work-up. Allergol. Immunopathol. 2020. 48. (5):p. 417-423. IF:1,667. (4).