Allergy to beta-lactam antibiotics in children: Risk factors for a positive diagnostic work-up

Data de publicação:

Autores da FMUP

  • Laura Virginia Pereira Teixeira Ribeiro

    Autor

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

Allergologia et Immunopathologia  Codon Publications

Tipo:
Article
Páginas:
417-423
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 6

Citações Recebidas na Scopus: 10

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Keywords

  • Drug allergy; Beta-lactam antibiotics; Children; Allergy diagnostic work-up; Risk factors

Proyectos asociados

Ensino-aprendizagem e perfil psicológico dos estudantes de medicina na pandemia Covid-19.

Investigador Principal: Laura Virginia Pereira Teixeira Ribeiro

Estudo Observacional Académico (PerfilPsic) . 2020

Catecholaminergic system regulation in adipose tissue under obesity

Investigador Principal: Laura Virginia Pereira Teixeira Ribeiro

Estudo Clínico Académico . 2020

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