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Hypersensitivity reactions to beta-lactams in children.
- Source :
-
Current opinion in allergy and clinical immunology [Curr Opin Allergy Clin Immunol] 2018 Aug; Vol. 18 (4), pp. 284-290. - Publication Year :
- 2018
-
Abstract
- Purpose of Review: To present the most recent evidence on beta-lactam hypersensitivity reactions in children.<br />Recent Findings: Drug provocation tests (DPTs) are the gold standard when investigating beta-lactam allergy in children and evidence is increasingly supporting DPTs without skin tests as a safe approach when evaluating children with nonimmediate mild reactions to beta-lactams. Of note, data are limited in the adolescent population, and this attitude may not apply to this age group. Standardization of DPT protocols is required in nonimmediate reactions, as many protocols ranging from 1 to 10 days have been described. The optimal duration of DPT is still unknown, with extended protocols providing slightly more sensitivity and possible higher long-term compliance, at the expense of potential side effects associated with prolonged antibiotic use. On the other hand, 1-day DPTs will identify the vast majority of patients, and the rest will only develop a mild rash during a subsequent full treatment. The natural history of beta-lactam allergy in children is not well studied with recent evidence pointing to the resolution of most confirmed beta-lactam allergies after 3 years.<br />Summary: Further studies are needed for the standardization of DPT protocols and to confirm the favourable natural history of beta-lactam drug allergies in children. In addition, multicentric studies are required to confirm the increasingly accepted position of performing DPTs without skin tests in nonimmediate mild reactions to beta-lactams and to further evaluate the possibility of performing DPTs in benign immediate reactions to beta-lactams in children.
- Subjects :
- Administration, Oral
Child
Drug Hypersensitivity blood
Drug Hypersensitivity immunology
Humans
Immunoglobulin E blood
Immunologic Tests adverse effects
Immunologic Tests standards
Predictive Value of Tests
beta-Lactamase Inhibitors administration & dosage
Drug Hypersensitivity diagnosis
Immunologic Tests methods
beta-Lactamase Inhibitors adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1473-6322
- Volume :
- 18
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Current opinion in allergy and clinical immunology
- Publication Type :
- Academic Journal
- Accession number :
- 29870460
- Full Text :
- https://doi.org/10.1097/ACI.0000000000000453