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The use of direct oral challenge to confirm allergies to penicillin class antibiotics in Danish children
BACKGROUND: A high number of children are referred to pediatric departments with a suspected allergic reaction to antibiotics. The prevalence of true allergy is considered to be significantly lower than shown from clinical history and symptoms alone. This study investigated the historical use of dir...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667840/ https://www.ncbi.nlm.nih.gov/pubmed/33190633 http://dx.doi.org/10.1186/s12887-020-02407-z |
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author | Krusenstjerna-Hafstrøm, Thomas Rubak, Sune |
author_facet | Krusenstjerna-Hafstrøm, Thomas Rubak, Sune |
author_sort | Krusenstjerna-Hafstrøm, Thomas |
collection | PubMed |
description | BACKGROUND: A high number of children are referred to pediatric departments with a suspected allergic reaction to antibiotics. The prevalence of true allergy is considered to be significantly lower than shown from clinical history and symptoms alone. This study investigated the historical use of direct oral challenges at three specialist pediatric departments in Denmark. METHODS: In this retrospective medical record review study, 141 children (69 boys and 72 girls) with a clinical history of suspected penicillin class allergy were investigated. A standardized questionnaire for drug allergy was completed in the beginning of the investigation, which also included a skin prick test (SPT), measurement of IgE to different types of penicillin, and a drug challenge (DC). RESULTS: Only four (2.8%) of the patients referred for further investigation in our study had a positive DC. We found no correlation between a positive DC, positive SPT or elevated specific IgE. None of the patients with a positive DC reacted with a rash alone prior to investigation. CONCLUSIONS: Allergy to penicillin in children is rare and probably overestimated. In children reacting to penicillin with a rash alone, our study indicated that the rash was probably not related to allergy and treatment should thus be continued. |
format | Online Article Text |
id | pubmed-7667840 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-76678402020-11-17 The use of direct oral challenge to confirm allergies to penicillin class antibiotics in Danish children Krusenstjerna-Hafstrøm, Thomas Rubak, Sune BMC Pediatr Research Article BACKGROUND: A high number of children are referred to pediatric departments with a suspected allergic reaction to antibiotics. The prevalence of true allergy is considered to be significantly lower than shown from clinical history and symptoms alone. This study investigated the historical use of direct oral challenges at three specialist pediatric departments in Denmark. METHODS: In this retrospective medical record review study, 141 children (69 boys and 72 girls) with a clinical history of suspected penicillin class allergy were investigated. A standardized questionnaire for drug allergy was completed in the beginning of the investigation, which also included a skin prick test (SPT), measurement of IgE to different types of penicillin, and a drug challenge (DC). RESULTS: Only four (2.8%) of the patients referred for further investigation in our study had a positive DC. We found no correlation between a positive DC, positive SPT or elevated specific IgE. None of the patients with a positive DC reacted with a rash alone prior to investigation. CONCLUSIONS: Allergy to penicillin in children is rare and probably overestimated. In children reacting to penicillin with a rash alone, our study indicated that the rash was probably not related to allergy and treatment should thus be continued. BioMed Central 2020-11-16 /pmc/articles/PMC7667840/ /pubmed/33190633 http://dx.doi.org/10.1186/s12887-020-02407-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Krusenstjerna-Hafstrøm, Thomas Rubak, Sune The use of direct oral challenge to confirm allergies to penicillin class antibiotics in Danish children |
title | The use of direct oral challenge to confirm allergies to penicillin class antibiotics in Danish children |
title_full | The use of direct oral challenge to confirm allergies to penicillin class antibiotics in Danish children |
title_fullStr | The use of direct oral challenge to confirm allergies to penicillin class antibiotics in Danish children |
title_full_unstemmed | The use of direct oral challenge to confirm allergies to penicillin class antibiotics in Danish children |
title_short | The use of direct oral challenge to confirm allergies to penicillin class antibiotics in Danish children |
title_sort | use of direct oral challenge to confirm allergies to penicillin class antibiotics in danish children |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667840/ https://www.ncbi.nlm.nih.gov/pubmed/33190633 http://dx.doi.org/10.1186/s12887-020-02407-z |
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