Gokcen Dilsa Tugcu

and 8 more

Background: Cystic fibrosis (CF) is reported to be a risk factor for drug hypersensitivity. However, there is conflicting data about true prevalence of drug allergy in children with CF. Methods: The suspicious drug hypersensitivity reactions (DHR) of children with CF were enquired by European Network for Drug Allergy (ENDA) questionnaire and skin tests and/or drug provocation tests were performed according to established guidelines. Results: Two hundred and nineteen children (48.9% boys; median [IQR] age, 8.4 years [4.8-12.4 years]) with cystic fibrosis were included in the study, from whom 22 patients with 24 suspected DHRs were evaluated. Most of the suspected DHRs were non-immediate (n=16, 66.6%) type and the offending drugs were amoxicillin clavulanic acid (n=7), macrolides (n=4), trimethoprim sulfamethoxazole (TMP/SMX) (n=2), piperacillin tazobactam (n=1), pancrelipase (n=1) and ursodeoxycholic acid (n=1). Eight (33.3%) of the DHRs were classified as immediate [ceftriaxone (n=2), ceftazidim (n=2), meropenem (n=1), ambisome (n=2), vancomycin (n=1)]. The main presenting clinical presentations were maculopapular eruption (41.6%) and urticaria (37.5%), accompanied by angioedema (8.3%), flushing (12.5%) and vomiting (8.3%). Nine skin tests (with beta-lactam protocol in 6 patients) and 24 DPTs were performed and none of the skin tests revealed a positive result, however 2 DPTs with TMP/SMX were positive. Conclusion: Actual drug allergy was demonstrated in 2 of 219 patients (0.9%) with nonbeta-lactam antibiotics. These results conflict with previous researches that showed higher drug allergy rates but were consistent with some recent studies. Numerous and long-term use of multiple drugs during management of cystic fibrosis may contribute to tolerance development.

Francesca Mori

and 10 more

Elif Soyak Aytekin

and 3 more

Background: Allergen immunotherapy(AIT) is an effective treatment for allergic rhinitis, asthma and venom allergy. Compliance is essential for AIT to obtain maximal benefit as it is a long term treatment. Objective: We aimed to evaluate the real life compliance of children with subcutaneous immunotherapy(SCIT) and tried to document the factors associated. Additionally how COVID-19 pandemic effected the compliance of the patients and the reasons of drop-outs were also evaluated. Method: Patients diagnosed with allergic rhinitis, allergic asthma or venom allergy and treated with SCIT between 2012 September, 2020 July were analyzed. Results: The study population comprised of 201 children (66,7% male) with a median (interquartile range) age of 12,8(9,4-15,2) years during the first injection of SCIT. The overall compliance rate before COVID-19 pandemic was 86,1%. Short AIT follow up time and venom allergy were found to be risk factors for drop out. The leading causes of drop outs were moving to another city/country(32,1%), improvement of symptoms(17,8%), ineffectiveness(14,2%) and adverse reactions(14,2%). During COVID-19 pandemic, among 108 patients receiving AIT, 31(28,7%) dropped out the therapy. The most frequent reasons for drop-outs were fear of being infected with COVID-19(35,4%) and thinking that the AIT practise stopped due to COVID-19 pandemic(29%). Male gender and older age were found to be the independent risk factors for drop out. Conclusion: The real life compliance in children was higher than in adults. Nearly one third of children dropped out during COVID-19 pandemic. Male gender and older age are associated with AIT drop out during COVID-19 pandemic.