Penicillin sensitivity among children without a positive history for penicillin allergy

Çetinkaya, Feyzullah; Çağ, Yakup

doi:10.1111/j.1399-3038.2004.00141.x

Cited by 32 publications

(14 citation statements)

References 16 publications

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“…The majority of these reactions occurred during aminopenicillin‐therapies followed by other penicillins and cefaclor. These results are comparable with other reports with slight differences most likely depending on drug usage patterns of the countries where the studies were conducted (8–10). The pattern of ADR‐related symptoms caused by antibiotics is different compared with studies in adult populations.…”

Section: Discussionsupporting

confidence: 91%

Questionnaire‐based survey of lifetime‐prevalence and character of allergic drug reactions in German children

Lange

Koningsbruggen

Rietschel

2008

Pediatric Allergy Immunology

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Data on the epidemiology of adverse drug reactions (ADR), especially allergic drug reactions, in children are rare. The reported prevalence of ADR in pediatric populations varies a lot, depending on type of the study and the country where the data were collected. In order to assess the prevalence of ADR and allergic drug reactions in a population of German children, we conducted a study in a German pediatric university hospital. A questionnaire concerning occurrence and character of ADR was distributed to all parents presenting their children in the hospital for planned admissions or in the emergency department from May 2004 to November 2004. Additional telephone interviews were conducted to specify the reported symptoms in ambiguous cases. One thousand four hundred forty-seven questionnaires were collected. The reported life-time prevalence of ADR according to the information given by the parents was 7.5% (108/1447). Six of the reactions were severe, three children had experienced anaphylactic reactions. In 4.2% (61/1447), the history was suspicious for a potential allergic mechanism because of an immediate or late phase cutaneous drug reaction. In this group, the suspected drugs were antibiotics in 85% (32.7% aminopenicillins, 29.5% other penicillins, 11.5% cefaclor, 8.2% macrolides and 18% others), antiphlogistic and respiratory drugs in 4.9% each and vaccines and contrast media in 3.3% each. There was a higher percentage of children under the age of four suffering from ADR. This trend was not significant when analyzing only the allergic reactions. Forty-four percent of the parents stated, their children suffer from drug allergy, although a clear non-allergic reaction was described. Both, ADR and allergic drug reactions are frequent phenomena in children. It is important to monitor drug therapy for any adverse reaction in order to inform the parents about the character of the adverse reaction, the necessary consequences and to initiate further diagnostic procedures.

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Section: Discussionsupporting

confidence: 91%

Questionnaire‐based survey of lifetime‐prevalence and character of allergic drug reactions in German children

Lange

Koningsbruggen

Rietschel

2008

Pediatric Allergy Immunology

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“…On the other hand, when the test is negative both for histamine and penicillin, it is interpreted as undetermined. The concentration of histamine is generally 1 mg/mL (Cetinkaya, Cag, 2004;Wall et al, 2004;Lammintausta, Kortekangas-Savolainen, 2005).…”

Section: Interpretation Of the Resultsmentioning

confidence: 99%

Implementation of a penicillin allergy skin test

Nagão-Dias

Pereira

Silva

et al. 2009

Braz. J. Pharm. Sci.

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The penicillin allergy skin testing is the only accurate and reliable test for penicillin hypersensitivity mediated by IgE. It is useful for identifying patients with doubtful history of allergy. Positive test for major and minor determinants presents a positive predictive value of 50% and negative predictive value of 99%. In Brazil, the Ministry of Health suggests a protocol for in house made reagents, since they are not commercially available. As the referred protocol does not mention some important details about the test procedures, we propose in the present work to implement them, critically evaluating each step in order to allow the protocol establishment at any health service, with quality and safety.Uniterms: Penicilin/allergy. Penicilin/cutaneous test. Skin test/penicilin allergy. Betalactamic/ hipersensitivity O teste cutâneo para alergia imediata a penicilina é o único teste validado internacionalmente, sendo que sua grande utilidade reside na avaliação de pacientes com história positiva de alergia a penicilina. O teste positivo para determinantes principais e secundários da penicilina apresenta um valor preditivo positivo de 50% e valor preditivo negativo de 99%. Em nosso meio, o Ministério de Saúde disponibiliza um protocolo para o preparo dos reagentes, uma vez que os mesmos não estão disponíveis comercialmente. Como o referido protocolo não apresenta maiores detalhes sobre o cuidado relativo às etapas de preparo das soluções, bem como faltam algumas considerações no que tange a realização do teste, propusemonos no presente trabalho operacionalizar o teste, avaliando de forma crítica e minuciosa cada etapa, de forma que outros profissionais possam reproduzi-lo de maneira mais segura e eficaz.Unitermos: Penicilina/alergia. Penicilina/teste cutâneo. Teste cutâneo/alergia penicilina. Betalactâmico/ hipersensibilidade.

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“…Although 10% of the children frequently treated with penicillins have immediate responses in skin tests [73] , immediate-reading skin tests have good diagnostic value in children with suspected ␤ -lactam HS. OC tests diagnosed immediatetype HS to ␤ -lactams in a few children with negative skin tests only [46,63] .…”

Section: ␤ -Lactamsmentioning

confidence: 99%

Allergy and Pseudoallergy to Drugs and Vaccines in Children

Ponvert¹,

Hadj‐Rabia²,

Scheinmann³

2007

Drug Hypersensitivity

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Five to 20% of subjects of all ages report suspected allergic reactions to drugs and biological substances. Children may be less affected than adults, but this difference is disputed and probably results from differences in drug exposure. Antibiotics, mainly ␤ -lactams, antipyretics, analgesics and non-steroidal anti-inflammatory drugs, are most frequently incriminated. The most common reactions are morbilliform/maculopapular rashes, urticaria and angioedema. Other cutaneous and systemic reactions and severe anaphylactic/anaphylactoid reactions are rare. Diagnosis is based on a detailed clinical history, skin and/or in vitro tests (if possible and if validated) and challenge tests (if indicated). Prevention of relapse is based on a rigorous avoidance of the responsible and cross-reacting drugs. The results of the allergological work-up, including challenge, are often negative, suggesting that, in many instances, the drug can be tolerated again. This is especially the case in mild to moderately severe reactions such as maculopapular exanthems, non-immediate urticarias and unidentified rashes. In these cases, the reaction may result from a complex interaction between 'danger' signals provided by the underlying disease and a weak and transient drug-specific immune reaction. However, severe reactions like anaphylaxis (caused by myorelaxants, etc.), bullous skin reactions or drug-induced rash with eosinophilia and systemic symptoms (antiepileptics), require the same precautions as in adults and strict avoidance of the incriminated drug, even if the test results are negative.

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Penicillin sensitivity among children without a positive history for penicillin allergy

Cited by 32 publications

References 16 publications

Questionnaire‐based survey of lifetime‐prevalence and character of allergic drug reactions in German children

Questionnaire‐based survey of lifetime‐prevalence and character of allergic drug reactions in German children

Implementation of a penicillin allergy skin test

Allergy and Pseudoallergy to Drugs and Vaccines in Children

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