Naslov
Diagnosis of immediate drug hypersensitivity reactions in children in Croatian Referral Center for Pediatric Allergy

Autori
I.Mrkić, D.Erceg, J. Marasović, D. Plavec, B. Nogalo, M. Turkalj

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
Congress EAACI

Mjesto i datum
Istanbul, Turska, 11.06.2011. - 15.06.2011

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
allergy, children, drug hypersensitivity reactions

Sažetak
INTRODUCTION: Drug allergy is an immunologically mediated response to a pharmaceutical agent in a sensitized person. It constitutes 6-10% of all adverse drug reactions. In children the most common are allergic reactions to antibiotics, which, as any other, can vary from mild reactions with skin symptoms only to severe, potentially life threatening anaphylactic reactions. The aim of this study was to determine the rate of drug allergic reactions in patients in our hospital during one-year period. MATERIAL AND METHODS: We collected history data of suspected drug allergic reactions and performed in vitro testing by “ImmunoCAP” method where possible. Skin prick test and intradermal test were done in all patients under a strict supervision and if they were negative we drug challenged them. All procedures were done according to EAACI guidelines. RESULTS: During one-year period we tested 88 children (51% male) with suspected drug allergic reactions. The most frequent drug suspected as cause of allergic reaction was amoxicillin in combination with clavulonic acid (25, 21.2%), followed by phenoxymethilpenicillin (19, 16.1%) and non steroidal anti inflammatory drugs (NSAID) and paracetamol (15, 12.7%) and cefuroxime-axetil (10, 8.47%). Most of these reactions were generalized rash (53.4%, and 73% from them were urticaria) or rashes combined with angioedema (11.86%). After performed testing we found 8 patients (9.1%) to have proven allergic reactions to drugs: one to amoxicillin, two to combination of amoxicillin and clavulonic acid, one to phenoxymethilpenicillin, one to cefuroxime and cefalexine, and one only to cefuroxime. The most severe reactions during testing were recorded to cefuroxime. Both patients with proven hypersensitivity had anaphylactic reactions, one to intradermal and other to minimal oral concentration of cefuroxime-axetil. CONCLUSION: Accurate identification of true nature of the drug reaction, and implications for future drug prescription is very important. Although adverse drug reactions and suspected drug allergy are frequently reported in children, the rate of proven allergic reactions is rather smaller then reported. Lack of knowledge can lead to fear of drug hypersensitivity and unnecessary avoidance of appropriate medications, with reliance on more expensive, or less effective alternatives, without a rational basis.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA