Published online January 2, 2008
PEDIATRICS Vol. 121 Supplement January 2008, pp. S92 (doi:10.1542/peds.2007-2022I)
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kavadas, F. D.
Right arrow Articles by Atkinson, A. R.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Kavadas, F. D.
Right arrow Articles by Atkinson, A. R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ALLERGOLOGY


ANTIBIOTIC SKIN TESTING FOR CHILDREN LABELED WITH TYPE 1 HYPERSENSITIVITY: A USEFUL CLINICAL TOOL

Fotini D. Kavadasa,b, Kimberley R. Seabana, Yehuda Nofech-Mozesa, Maitham Husaina, Elisabeth Whitea and Adelle R. Atkinsona,b

a Division of Immunology and Allergy
b Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada

ABSTRACT

INTRODUCTION: Children are often unnecessarily labeled as being allergic to antibiotics that may potentially be life saving. Aside from penicillin, good diagnostic testing has not been available in pediatrics to differentiate between type 1 hypersensitivity and other causes of adverse reactions to antibiotics.

OBJECTIVE: We sought to determine the safety of antibiotic skin testing of children and to describe its potential clinical impact.

METHODS: A retrospective chart review was performed of patients between 0 and 18 years of age who were seen in our clinic over a 2-year period with a history of a possible immunoglobulin E–mediated reaction to various antibiotics other than penicillin. We included patients with either extremely limited antibiotic options or complex medical issues that require antibiotics. We did not perform testing if there was a history of a convincing immunoglobulin E–mediated or serum sickness–like reaction. Skin testing was performed by using nonirritating concentrations of the antibiotic in question that have been used in adults. If skin-prick testing results were negative, we performed intradermal testing. A provocative challenge was offered if all skin-testing results were negative.

RESULTS: of 28 visits, 23 met our inclusion criteria; 4 (17%) of 23 could not be skin-tested. Of those who were skin-prick–tested, all 19 (100%) had a negative result, and 17 (89%) of 19 also had a negative intradermal test. Of those 17 (88%), 15 patients agreed to undergo provocative challenge, 14 (93%) of whom were then unlabeled as allergic to the respective antibiotic.

CONCLUSIONS: Skin-prick testing is a novel tool in pediatrics that may have an important clinical impact in the accurate diagnosis of antibiotic allergies by guiding provocative challenges.

Submitted by Fotini D. Kavadas


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?