Methods
Prospective study evaluating children aged under 16 years reporting DHRs
to beta-lactams. Reactions were classified as immediate and nonimmediate
reactions. The work-up included sIgE, skin testing and drug provocation
tests (DPTs) for immediate reactions and patch testing and DPTs for
nonimmediate ones.
ResultsOf the 510 included children, 133 were evaluated for immediate reactions
and confirmed in 8.3%. Skin test/in vitro IgE contributed to diagnosing
half of the cases. Selective reactions occurred with amoxicillin (63%),
followed by common penicillin determinants (27%) and cephalosporins
(0.9%).
Among nonimmediate reactions (11,4% of the 377 children evaluated),
most required DPTs, 52.7% of which were positive at 6–7 days of drug
challenge. Selective reactions were identified with amoxicillin (80%),
penicillin G (7.5%), cephalosporins (7.5%), and clavulanic acid (5%).
Urticaria and maculopapular exanthema were the most frequent entities.