oa Current Allergy & Clinical Immunology - An update on the management of antibiotic allergy in children : review article

Volume 26, Issue 3
  • ISSN : 1609-3607



Suspicions of antibiotic allergy are very common in children, but true allergic reactions are rare and clearly overdiagnosed, representing a major public health problem. Indeed, viral skin rashes are very common, and children are falsely labelled as 'penicillin allergic' mostly because of fear of an anaphylactic reaction. Highlighting the most recent literature, this current review focuses on the management of the child with a possible antibiotic allergy. Systematic approaches have been proposed for the management of children with a suspicion of antibiotic allergy. Although essential, clinical history is not sufficient and a complete allergic work-up is required in all children with a suspicion of antibiotic allergy. Allergological tests will be adapted, depending if an immediate or a non-immediate reaction is suspected. The drug provocation test is considered the gold standard and has gained in importance, particularly in children developing a benign rash during a beta-lactam treatment. However, this test is associated with a potential risk of severe reaction, has relevant cost and is time-consuming. Several new diagnostic tests are currently under investigation and provide promising results. An accurate diagnosis of antibiotic allergy is important not only to avoid severe allergic reactions but also to decrease the number of patients incorrectly labelled as allergic to antibiotics.

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