ABSTRACT

Beta-lactam antibiotics (BLA) are the most common drugs that cause drug-related hypersensitivity reactions in children. However, more than 95% of patients can safely use penicillins when properly evaluated. In this study, we aimed to evaluate the actual frequency of BLA allergy by examining the clinical characteristics of the patients, diagnostic evaluation of drug allergy tests and results in patients presenting with suspected BLA allergy.

In the study, 44 children who admitted to a pediatric allergy outpatient clinic in a tertiary care center with suspected BLA allergy in a one-year period were evaluated retrospectively.

A total of 44 children (male/female: 24/20) with suspected BLA allergy were included in the study. 38.6% (n=17) of the patients had a history of allergic disease, 36.4% (n=16) had a family history of allergic disease. The most frequently reported culprit drug was amoxicillin clavulonate (75%) and the most common cause of antibiotic usage was acute tonsillitis (56.8%). Skin findings (97.7%) were the most common clinical presentation. As a result of the allergic evaluation, a total of 5 patients (11%) were found to have BLA allergy. There was no significant difference between children with BLA allergy and those who were not, in terms of age, gender, atopy or family history of drug allergy (p>0.05).

After diagnostic evaluation, it has been shown that BLA hypersensitivity is actually present in a small number of cases that are considered to be suspected allergic reactions only with history. In children with a history of allergic reactions to BLAs, an appropriate drug allergy assessment is required in line with a detailed clinical history in order to establish the correct diagnosis confidently and not to label patients with a diagnosis of drug allergy unnecessarily.