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).