Diagnosis
BLs still are the most commonly prescribed and used antibiotics in
children. Viral infection can provoke skin rashes such as MPE or
urticaria, therefore it is difficult to differentiate DHRs from skin
symptoms due to infections.4,5 There must be at least
one exposure before the index reaction, but we have to keep in mind that
a previous sensitization can be unsuspected and due to
cross-reactivity.3 About 10% of parents report
suspected allergy to at least one BLs in their
children.6 So the most of children are labeled as
‘drug allergic’. But, after a proper evaluation, allergy will be
confirmed only in a small percentage of children, indicating that true
allergy to BLs is rare and overdiagnosed.7-9 Because
of that, the diagnosis of BLs hypersensitivity in children is still an
important and hot topic.10
Most information about approach and management on BLs hypersensitivity
in children is applied from available guidelines and consensus statement
for adults.6,11
The first step in the diagnostic work up is complete and precise
clinical history. It is essential to differentiate between an adverse
reaction and a real DHR, as well as, whether is an IR and NIR. The
following steps will vary depending on type of reaction (IR or NIR).