Provocation Tests in Nonimmediate Hypersensitivity Reactions to β-Lactam Antibiotics in Children: Are Extended Challenges Needed?
| Autor: | Jesús M. Borja Segade, Lucia Moreno Lozano, Pedro A. Galindo Bonilla, Elisa Gómez Torrijos, Alba Extremera Ortega, Rosa Garcia Rodriguez |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Allergy Adolescent medicine.drug_class Provocation test Antibiotics Positive reaction Administration Oral beta-Lactams Observational period Drug Hypersensitivity 03 medical and health sciences 0302 clinical medicine Maculopapular exanthema Immunology and Allergy Medicine Humans Hypersensitivity Delayed 030212 general & internal medicine Child Retrospective Studies business.industry Infant Retrospective cohort study Allergens medicine.disease Anti-Bacterial Agents 030228 respiratory system Repeated doses Anesthesia Child Preschool Female Immunization business |
| Zdroj: | The journal of allergy and clinical immunology. In practice. 7(1) |
| ISSN: | 2213-2201 |
| Popis: | Background β-Lactam antibiotics are the most common trigger of reactions in children with most of them being nonimmediate (85.5%), but proven allergy after the allergological workup is between 7% and 10%. There is no agreement on how to perform the provocation tests in these types of hypersensitivity reactions. Objective To determine whether or not repeated doses of the β-lactams are required to reproduce a nonimmediate reaction in children. Methods This is a retrospective observational study. We included children under 14 years who were referred for a nonimmediate reaction to β-lactams. All patients underwent a 1-day hospital provocation and were kept under observation at home during the following days for at least the time elapsed between the first dose and the symptoms of the index reaction. If no reaction was triggered, the patient resumed the provocation at home with 2 daily therapeutic doses for an equal of interval time. Results Ninety-seven patients were included in the study. A positive reaction was recorded in 14 of them (14.4%). The short hospital provocation triggered 3 immediate reactions and 8 delayed reactions. The home rechallenge developed 1 immediate reaction and 2 delayed reactions. Conclusions Nonimmediate reactions to β-lactams in children may be triggered with a 1-day provocation test. We suggest to perform a 1-day provocation test followed by an observational period of at least the time interval of the index reaction. If this challenge is negative, an extended home provocation could subsequently be carried out. |
| Databáze: | OpenAIRE |
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