Hypersensitivity reactions to non-betalactam antibiotics in children: An extensive review

On Behalf of Pediatric Task Force of EAACI Drug Allergy Interest Group

Research output: Contribution to journalReview articlepeer-review

49 Scopus citations

Abstract

In contrast to hypersensitivity reactions (HSRs) to β-lactam antibiotics in children, studies about HSR to non-β-lactam antibiotics (NBLAs) such as sulfonamides, macrolides, quinolones, and antituberculosis agents are scarce, and information is generally limited to case reports. The aim of this extensive review was to summarize our present knowledge on clinical characteristics, evaluation, and management of HSR to NBLAs in children based on the literature published between 1980 and 2013. NBLAs have been reported to induce a wide spectrum of HSRs from mild eruptions to severe, and sometimes fatal, systemic drug reactions, especially in some high-risk groups. The diagnosis relied upon history and remained unconfirmed by allergological tests in most of the cases. Obtaining a detailed history is valuable in the diagnosis of suspected reactions to NBLAs. Diagnostic in vivo and in vitro tests for NBLAs lack validation, which makes the diagnosis challenging. The definitive diagnosis of NBLA hypersensitivity frequently depends upon drug provocation tests. Studies including children showed that only 7.8 to 36% of suspected immediate and delayed HSRs to NBLAs could be confirmed by skin and/or provocation tests. Therefore, a standardized diagnostic approach and management strategy should be developed and employed for pediatric patients in the evaluation of suspected HSRs to NBLAs, some of which may be critical and unreplaceable in certain clinical situations.

Original languageEnglish
Pages (from-to)534-543
Number of pages10
JournalPediatric Allergy and Immunology
Volume25
Issue number6
DOIs
StatePublished - 1 Oct 2014

Keywords

  • Children
  • Diagnosis
  • Drug allergy
  • Drug hypersensitivity
  • Non-beta(β)lactam antibiotics
  • Skin tests

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