Exanthematous reactions to drugs in children

Abstract

Purpose of reviewThe true exanthematous reactions to drugs in children are rare and overdiagnosed. Drugs may cause exanthema either due to inducing an immune response or because of their interaction with viruses, if drugs are taken in the course of a viral infection. Also, viral infections are very often in children and they can provoke an exanthema which is difficult to differentiate from exanthematous reactions to drugs. Consequently, the majority of children are incorrectly labeled as 'allergic'. Recent findingsThe correct diagnosis of exanthematous drug reactions in children is still an important and hot topic. Most information about the approach and management of drug hypersensitivity in children is applied from available guidelines and consensus statement for adults. Recently, a systematic clinical approach for timely differential diagnosis and management of rashes in children who present a cutaneous exanthema while receiving a drug, is proposed.

Simplifying the drug provocation test in non‐immediate hypersensitivity reactions to amoxicillin in children: The experience of a tertiary care allergy unit

“…In addition, a prolonged DPT results in increased confidence in the future use of the same drug when compared with a single‐day DPT. On the other hand, a prolonged DPT is questioned because of its impact on the gut microbiota and the potential risk of increasing antibiotic resistance 1,3,8–24 . So far there is no agreement on the best protocol to be used that reaches the best compromise between safety, time consumption, and potential side effects.…”

“…On the other hand, a prolonged DPT is questioned because of its impact on the gut microbiota and the potential risk of increasing antibiotic resistance. 1,3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] So far there is no agreement on the best protocol to be used that reaches the best compromise between safety, time consumption, and potential side effects. Today it is a matter of debate the way of administering the first dose of antibiotic during the DPT, in particular, if it would be better to fraction or not the drug dose (calculated according to the bodyweight).…”

Editorial: Advances in drug hypersensitivity reactions

“…In the review of Atanaskovic-Markovic and Tsabouri drug-induced exanthema in children is updated, including not only benign exanthemas but also those that appear in other entities like acute exanthematic pustulosis [4]. Maculopapular exanthema are confirmed as being drug hypersensitivity in only a minority of cases; although the assessment is often limited as children are frequently reviewed many years after the reaction took place.…”