The Journal of Allergy and Clinical Immunology: In Practice
Original ArticleAsthma, Family History of Drug Allergy, and Age Predict Amoxicillin Allergy in Children
Section snippets
Study cohort
The study was performed at the Wolfson Medical Center, Holon, Israel. Included in the study were children who had been referred to the Allergy unit in our center from January 1, 2013, to December 31, 2015, with a suspected allergic reaction to amoxicillin or amoxicillin-clavulanate antibiotic. Patients with a history of a severe cutaneous adverse reaction (eg, Stevens-Johnson syndrome/toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, and acute generalized
Results
Characteristics of study participants and clinical reactions are described in Table I. In summary, most of the reactions presented with generalized rash and were delayed (appeared more than 1 hour after the drug administration). None of the participants had cardiovascular involvement. A significant fraction of the patients had a personal or family history of atopy (asthma, food allergy, allergic rhinitis, or atopic dermatitis) and family history of drug allergy.
The results of SPT and OGC are
Discussion
It has been shown previously that amoxicillin allergy is overdiagnosed in children and can only rarely be reproduced by OGC.3 In most cases, these so-called allergic reactions are mild and limited to the skin and related to concomitant viral infections. In contrast to other allergic phenomena, such as asthma and allergic rhinitis or eczema and food allergy, there is no clear association between atopy and drug allergy. There have been a few attempts in the past to find risk factors for drug
References (32)
Risk factors for drug allergy
J Allergy Clin Immunol
(1984)- et al.
Self-reported antibiotic allergy incidence and prevalence: age and sex effects
Am J Med
(2009) - et al.
Treatment of patients with a history of penicillin allergy in a large tertiary-care academic hospital
J Allergy Clin Immunol Pract
(2013) - et al.
Safely diagnosing clinically significant penicillin allergy using only penicilloyl-poly-lysine, penicillin, and oral amoxicillin
J Allergy Clin Immunol Pract
(2013) - et al.
The role of penicillin in benign skin rashes in childhood: a prospective study based on drug rechallenge
J Allergy Clin Immunol
(2011) - et al.
Drug-resistant infections with methicillin-resistant Staphylococcus aureus, Clostridium difficile, and vancomycin-resistant enterococcus are associated with a higher prevalence of penicillin allergy
J Allergy Clin Immunol
(2013) - et al.
Penicillin skin testing is a safe and effective tool for evaluating penicillin allergy in the pediatric population
J Allergy Clin Immunol Pract
(2014) - et al.
Penicillin skin testing in the evaluation and management of penicillin allergy
Ann Allergy Asthma Immunol
(2011) - et al.
Skin testing only with penicillin G in children with a history of penicillin allergy
Ann Allergy Asthma Immunol
(2014) - et al.
Evaluation of penicillin hypersensitivity: value of clinical history and skin testing with penicilloyl-polylysine and penicillin G. A cooperative prospective study of the penicillin study group of the American Academy of Allergy
J Allergy Clin Immunol
(1977)
Prediction of penicillin allergy by immunological tests
J Allergy
Immediate-type drug hypersensitivity and associated factors in a general population
Allergol Immunopathol (Madrid)
Costs of beta-lactam allergies: selection and costs of antibiotics for patients with a reported beta-lactam allergy
Arch Fam Med
The incidence of antimicrobial allergies in hospitalized patients: implications regarding prescribing patterns and emerging bacterial resistance
Arch Intern Med
The economic burden of antibiotic treatment of penicillin-allergic patients in internal medicine wards of a general tertiary care hospital
Clin Exp Allergy
Drug allergy: an updated practice parameter
Ann Allergy Asthma Immunol
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Conflicts of interest: The authors declare that they have no relevant conflicts of interest.