Oral challenge to drugs in pediatrics – casuistry 2015
Keywords:Allergy, drugs, oral challenge
Introduction: Suspected drug allergy in the pediatric population is a frequent reason for consultation. However, it is rarely confirmed. Thus, the oral challenge (OC) assumes a significant role in the diagnostic approach.
Objectives: Characterize a pediatric population of a level II hospital submitted to OC to drugs, assess which drugs where implicated and analyze the cases in which the OC was positive.
Materials and methods: Clinical records of the patients submitted to OC to drugs in the period of January 1st to December 31st 2015, younger than 18 years.
Results: The sample included 58 patients, 53.4% male. The median age was five years. Most were referred from the emergency room (39.7%) and the outpatient clinic (36.2%). Amoxicillin was the suspected drug in 46.6% and when associated with clavulanic acid in 34.5%. About 93.1% had mucocutaneous manifestations, 5.2% gastrointestinal and mucocutaneous and 1.7% respiratory and mucocutaneous. In 20.7% of the cases, symptoms occurred during the first 24 hours. In three patients the OC was positive and the responsible drug was amoxicillin in two cases and ibuprofen in one.
Conclusions: Allergy to drugs is rare in children but, considering its relevance in the management of infectious situations, it becomes important to refer all suspected cases to clarify the diagnosis.
KGomes ER, Brockow K, Kuyucu S, Saretta F, Mori F, Blanca-Lopez N et al. Drug hypersensivity in children: report from the pediatric task force of the EAACI Drug Allergy Interest Group. Allergy 71. 2016; 149-61.
Park MA, Koch CA, Klemawesch P, Joshi A, Li JT. Increased adverse drug reactions to cephalosporins in penicilin allergy patients with positive penicillin skin test. Int Arch Allergy Immunol. 2010; 153:268-73.
Blanca M, Romano A, Torres MJ, Férnandez J, Mayorga C, Rodriguez J et al. Update on the evaluation of hypersensitivity reactions to betalactams. Allergy 2009; 64:183–93.
Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA et al. International Consensus on drug allergy. Allergy 69. 2014: 420-37.
Mayorga C, Celik G, Rouzaire P, Whitaker P, Bonadonna P, Rodrigues-Cernadas J et al. In vitro tests for drug hypersensitivity reactions na ENDA/ EAACI Drug Allergy Interest Group position paper. Allergy 2016; doi: 10.1111/all.12886.
Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P et al. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy 2002; 57:45-51.
Romano A, Blanca M, Torres MJ, Bircher A, Aberer W, Brockow K et al. Diagnosis of non imediate reactions to beta-lactam antibiotics. Allergy 2004; 59:1153-60.
Demoly P, Romano A, Botelho C, Bousquet-Rouanet L, Gaeta F, Silva R et al. Determining the negative predictive value of provocation tests with beta-lactams. Allergy 65. 2010; 327-32.
How to Cite
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.