Parent-reported penicillin allergies in children: A qualitative study

Carter, Eileen J.; Kaman, Kelsey; Baron, Katelyn; Miller, Michael; Krol, David; Harpalani, Divya; Aseltine, Robert H.; Pagoto, Sherry L.

doi:10.1016/j.ajic.2022.04.008

Cited by 2 publications

(5 citation statements)

References 31 publications

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“…A very recent study 32 analyzed parent‐reported penicillin allergy in children through surveys to the parents, and the authors concluded that most of them were unaware of the meaning and consequences of a true hypersensitivity, which had not been investigated. A paper by Wong et al 33 .…”

Section: Discussionmentioning

confidence: 99%

“…30 The paper of Strömberg Celind et al about children with asthma showed a good agreement between the questionnairebased data provided by parents and the National Drug Register. 31 A very recent study 32 analyzed parent-reported penicillin allergy in children through surveys to the parents, and the authors concluded that most of them were unaware of the meaning and consequences of a true hypersensitivity, which had not been investigated.…”

Section: Characteristics Of the Patients And Their History Of Reactionmentioning

confidence: 99%

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The importance of clinical history in the diagnosis of drug hypersensitivity in children

Liccioli,

Tomei,

Pessina

et al. 2024

Pediatric Allergy Immunology

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BackgroundIn case of suspected hypersensitivity reactions (HRs) to drugs, a challenging area for pediatricians is detecting relevant elements in the parent‐reported history, in order to reach a definite diagnosis. We analyzed the concordance between the description of the HR and the medical reports documented at the time of the event. Furthermore, we studied any correlation between clinical history variables and the prediction of true allergy.MethodsWe retrospectively collected 50 charts of children referred to our Allergy Unit, after a previous access to the Emergency Department. We compared the description of the HR at acute phase to the history told by parents. Type and timing of the HR and culprit drug were classified as “known” or “unknown.” The diagnosis was confirmed or excluded at the end of the investigations. Logistic regression analysis was performed to find any significant association.ResultsThe type of the HR was known in 74%, the timing in 28%, and the culprit drug in 98%. We showed that having had a severe HR had an increased odds of remembering the timing; being older >6 years and having had an immediate HR had an increased odds of remembering the type; time to diagnostic was lower in patients whose parents remembered the type of HR.ConclusionOur paper underlines the importance of an accurate anamnesis at the time of the event. Providing the physicians with a standardized Case Report Form could be a useful tool to simplify the diagnostic work‐up and minimize mistakes due to lack of memory.

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Section: Discussionmentioning

confidence: 99%

Section: Characteristics Of the Patients And Their History Of Reactionmentioning

confidence: 99%

The importance of clinical history in the diagnosis of drug hypersensitivity in children

Liccioli,

Tomei,

Pessina

et al. 2024

Pediatric Allergy Immunology

View full text Add to dashboard Cite

show abstract

“…34 A recent qualitative study of parents penicillin allergy in children found common misconceptions among parents, including the belief that penicillin allergies were hereditary and harmless. 37 In this study, parents became receptive to penicillin allergy testing after becoming aware of the frequency of falsely reported penicillin allergies, harms associated with a reported penicillin allergy, and the availability of penicillin allergy testing. 37 Thus, efforts to improve the uptake of penicillin allergy testing among children should address the common misconceptions of parents regarding penicillin allergy while amplifying factors that may motivate parents to undergo testing.…”

Section: Discussionmentioning

confidence: 99%

“…37 In this study, parents became receptive to penicillin allergy testing after becoming aware of the frequency of falsely reported penicillin allergies, harms associated with a reported penicillin allergy, and the availability of penicillin allergy testing. 37 Thus, efforts to improve the uptake of penicillin allergy testing among children should address the common misconceptions of parents regarding penicillin allergy while amplifying factors that may motivate parents to undergo testing. Complex ED workflows challenge the successful implementation of penicillin allergy testing in the pediatric ED.…”

Section: Discussionmentioning

confidence: 99%

“…Among 229 children who met low-risk symptoms of reported penicillin allergy, 49% (113) of parents were not interested in the oral amoxicillin challenge 34 . A recent qualitative study of parents reporting penicillin allergy in children found common misconceptions among parents, including the belief that penicillin allergies were hereditary and harmless 37 . In this study, parents became receptive to penicillin allergy testing after becoming aware of the frequency of falsely reported penicillin allergies, harms associated with a reported penicillin allergy, and the availability of penicillin allergy testing 37 .…”

Section: Discussionmentioning

confidence: 99%

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Documented Penicillin Allergies on Antibiotic Selection at Pediatric Emergency Department Visits

Carter,

Zavez,

Rogers

et al. 2023

Pediatr Emer Care

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Background Penicillin or amoxicillin are the recommended treatments for the most common pediatric bacterial illnesses. Allergies to penicillin are commonly reported among children but rarely true. We evaluated the impact of reported penicillin allergies on broad-spectrum antibiotic use overall and for the treatment of common respiratory infections among treat-and-release pediatric emergency department (ED) visits. Methods Retrospective cohort study of pediatric patients receiving antibiotics during a treat-and-release visit at a large, pediatric ED in the northeast from 2014 to 2016. Study exposure was a reported allergy to penicillin in the electronic medical record. Study outcomes were the selection of broad-spectrum antibiotics and alternative (second-line) antibiotic therapy for the treatment of acute otitis media (AOM) and group A streptococcus (GAS) pharyngitis. We used unadjusted and adjusted generalized estimating equation models to analyze the impact of reported penicillin allergies on the selection of broad-spectrum antibiotics. We used unadjusted and adjusted logistic regression models to determine the probability of children with a documented penicillin allergy receiving alternative antibiotic treatments for AOM and GAS. Results Among 12,987 pediatric patients, 810 (6.2%) had a documented penicillin allergy. Penicillin allergies increased the odds of children receiving a broad spectrum versus narrow spectrum antibiotic (adjusted odds ratio, 13.55; 95% confidence interval (CI), 11.34–16.18). In our adjusted logistic regression model, the probability of children with a documented penicillin allergy receiving alternative antibiotic treatment for AOM was 0.97 (95% CI, 0.94–0.99) and for GAS was 0.97 (95% CI, 0.92–0.99). Conclusions Antibiotic stewardship efforts in pediatric EDs may consider the delabeling of penicillin allergies particularly among children receiving antibiotics for an acute respiratory infection as a target for intervention.

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Parent-reported penicillin allergies in children: A qualitative study

Cited by 2 publications

References 31 publications

The importance of clinical history in the diagnosis of drug hypersensitivity in children

The importance of clinical history in the diagnosis of drug hypersensitivity in children

Documented Penicillin Allergies on Antibiotic Selection at Pediatric Emergency Department Visits

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