Drug Allergy: 5- year Case Series

Goals: Drug allergy suspicion is a frequent reason for referral to allergology specialty in pediatric age. However, this suspicion is rarely confirmed, and the drug provocation test (DPT) is fundamental for the diagnosis. Thus, with this work we intend to characterize the pediatric population with suspected drug allergy referred to the Pediatric Allergology consultation.

Method: Retrospective analysis of the clinical processes of children (

Results: The sample included 118 children, 54% female, with an average age of 5 years and 2 months (range from 5 months to 18 years). 38 children had a personal history of atopy, including recurrent wheezing and atopic dermatitis, and 29 children had an history of allergy in first-degree relatives. The reactions that increased the suspicion of drug allergy were mostly mucocutaneous (n= 107) and gastrointestinal (n=11). 49 children were observed in the emergency service for this reason. They were medicated with isolated antihistamine (n=33), antihistamine + corticosteroid (n= 11) and antihistamine + corticosteroid + adrenaline (n=5). IgEs were specifically quantified in 106 cases (for Amoxicillin, Ampicilloil and Penicilloic G and V), with a positive result in only 2. DPT were performed for antibiotics (amoxicillin (n= 53), amoxicillin/clavulanic acid (n= 49), penicillin (n=4), cefuroxime (n= 2), azithromycin (n= 1), cefixime (n= 1)), paracetamol (n=5) and ibuprofen (n=1), with a positive result in 4 children. Verified reactions were mucocutaneous and gastrointestinal, without cases of anaphylaxis.

Conclusion: Drug allergy in children is an important topic of debate, as overdiagnosis is quite common, hindering the clinical approach and leading to the eviction of several first-line therapies. Thus, we want to alert to the importance of an early referral in order to obtain a correct and clear diagnosis.