Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in children
Background Beta-lactams generate different allergenic determinants that induce selective or cross-reactive drug hypersensitivity reactions (DHRs). We aimed to identify the drugs involved, the selectivity of the response, the mechanism, and the value of the different diagnostic tests for establishing...
| Autores: | , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2021 |
| País: | España |
| Institución: | Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL) |
| Repositorio: | r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante |
| OAI Identifier: | oai:isabial.fundanetsuite.com:p7261 |
| Acceso en línea: | https://isabial.portalinvestigacion.com/publicaciones7261 |
| Access Level: | acceso abierto |
| Palabra clave: | beta-lactams children hypersensitivity immediate reaction non-immediate reactions |
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Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in childrenTorres-Rojas, IsabelPerez-Alzate, DianaLuisa Somoza, MariaHaroun Diaz, ElisaRuano Perez, Francisco JavierPrieto-Moreno Pfeifer, AnaJimenez-Rodriguez, Teodorikez W.Fernandez Sanchez, JavierBlanca Gomez, MiguelCanto Diez, GabrielaBlanca-Lopez, Nataliabeta-lactamschildrenhypersensitivityimmediate reactionnon-immediate reactionsBackground Beta-lactams generate different allergenic determinants that induce selective or cross-reactive drug hypersensitivity reactions (DHRs). We aimed to identify the drugs involved, the selectivity of the response, the mechanism, and the value of the different diagnostic tests for establishing a diagnosis in children evaluated for DHRs to beta-lactams. Methods Prospective study evaluating children aged under 16 years reporting DHRs to beta-lactams. Reactions were classified as immediate and non-immediate reactions. The workup included sIgE, skin testing, and drug provocation tests (DPTs) for immediate reactions and patch testing and DPTs for non-immediate ones. Results Of the 510 children included, 133 were evaluated for immediate reactions and confirmed in 8.3%. Skin test/in vitro IgE contributed to diagnosing half of the cases. Selective reactions occurred with amoxicillin (63%), followed by common penicillin determinants (27%) and cephalosporins (0.9%). Among non-immediate reactions (11.4% of the 377 children evaluated), most required DPTs, 52.7% of which were positive at 6-7 days of drug challenge. Selective reactions were identified with amoxicillin (80%), penicillin G (7.5%), cephalosporins (7.5%), and clavulanic acid (5%). Urticaria and maculopapular exanthema were the most frequent entities. Conclusions There were few confirmed cases of either type of reaction. Skin testing proved less valuable in non-immediate reactions, over half of which would also have been lost in a short DPT protocol. Selective responders to amoxicillin were more likely to have non-immediate reactions, while clavulanic acid selectivity was exclusive to the non-immediate typology. Over half the cases with DPTs required 6-7 days of treatment for DHR confirmation.WILEY-BLACKWELL PUBLISHING, INC2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones7261PEDIATRIC ALLERGY AND IMMUNOLOGYISSN: 09056157ISSNe: 13993038reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p72612026-06-12T10:20:37Z |
| dc.title.none.fl_str_mv |
Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in children |
| title |
Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in children |
| spellingShingle |
Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in children Torres-Rojas, Isabel beta-lactams children hypersensitivity immediate reaction non-immediate reactions |
| title_short |
Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in children |
| title_full |
Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in children |
| title_fullStr |
Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in children |
| title_full_unstemmed |
Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in children |
| title_sort |
Patterns of response and drugs involved in hypersensitivity reactions to beta-lactams in children |
| dc.creator.none.fl_str_mv |
Torres-Rojas, Isabel Perez-Alzate, Diana Luisa Somoza, Maria Haroun Diaz, Elisa Ruano Perez, Francisco Javier Prieto-Moreno Pfeifer, Ana Jimenez-Rodriguez, Teodorikez W. Fernandez Sanchez, Javier Blanca Gomez, Miguel Canto Diez, Gabriela Blanca-Lopez, Natalia |
| author |
Torres-Rojas, Isabel |
| author_facet |
Torres-Rojas, Isabel Perez-Alzate, Diana Luisa Somoza, Maria Haroun Diaz, Elisa Ruano Perez, Francisco Javier Prieto-Moreno Pfeifer, Ana Jimenez-Rodriguez, Teodorikez W. Fernandez Sanchez, Javier Blanca Gomez, Miguel Canto Diez, Gabriela Blanca-Lopez, Natalia |
| author_role |
author |
| author2 |
Perez-Alzate, Diana Luisa Somoza, Maria Haroun Diaz, Elisa Ruano Perez, Francisco Javier Prieto-Moreno Pfeifer, Ana Jimenez-Rodriguez, Teodorikez W. Fernandez Sanchez, Javier Blanca Gomez, Miguel Canto Diez, Gabriela Blanca-Lopez, Natalia |
| author2_role |
author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
beta-lactams children hypersensitivity immediate reaction non-immediate reactions |
| topic |
beta-lactams children hypersensitivity immediate reaction non-immediate reactions |
| description |
Background Beta-lactams generate different allergenic determinants that induce selective or cross-reactive drug hypersensitivity reactions (DHRs). We aimed to identify the drugs involved, the selectivity of the response, the mechanism, and the value of the different diagnostic tests for establishing a diagnosis in children evaluated for DHRs to beta-lactams. Methods Prospective study evaluating children aged under 16 years reporting DHRs to beta-lactams. Reactions were classified as immediate and non-immediate reactions. The workup included sIgE, skin testing, and drug provocation tests (DPTs) for immediate reactions and patch testing and DPTs for non-immediate ones. Results Of the 510 children included, 133 were evaluated for immediate reactions and confirmed in 8.3%. Skin test/in vitro IgE contributed to diagnosing half of the cases. Selective reactions occurred with amoxicillin (63%), followed by common penicillin determinants (27%) and cephalosporins (0.9%). Among non-immediate reactions (11.4% of the 377 children evaluated), most required DPTs, 52.7% of which were positive at 6-7 days of drug challenge. Selective reactions were identified with amoxicillin (80%), penicillin G (7.5%), cephalosporins (7.5%), and clavulanic acid (5%). Urticaria and maculopapular exanthema were the most frequent entities. Conclusions There were few confirmed cases of either type of reaction. Skin testing proved less valuable in non-immediate reactions, over half of which would also have been lost in a short DPT protocol. Selective responders to amoxicillin were more likely to have non-immediate reactions, while clavulanic acid selectivity was exclusive to the non-immediate typology. Over half the cases with DPTs required 6-7 days of treatment for DHR confirmation. |
| publishDate |
2021 |
| dc.date.none.fl_str_mv |
2021 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
https://isabial.portalinvestigacion.com/publicaciones7261 |
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https://isabial.portalinvestigacion.com/publicaciones7261 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
| dc.publisher.none.fl_str_mv |
WILEY-BLACKWELL PUBLISHING, INC |
| publisher.none.fl_str_mv |
WILEY-BLACKWELL PUBLISHING, INC |
| dc.source.none.fl_str_mv |
PEDIATRIC ALLERGY AND IMMUNOLOGY ISSN: 09056157 ISSNe: 13993038 reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL) |
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Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL) |
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r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante |
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r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante |
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1869405148145516544 |
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15,81155 |