Azithromycin Anaphylaxis in Children

@article{Mori2014AzithromycinAI,
  title={Azithromycin Anaphylaxis in Children},
  author={Francesca Mori and Lisa Pecorari and Stefano Pantano and Maria Elisabetta Rossi and Neri Pucci and Maurizio de Martino and Elio Novembre},
  journal={International Journal of Immunopathology and Pharmacology},
  year={2014},
  volume={27},
  pages={121 - 126}
}
Allergic reactions associated to the use of macrolides are uncommon; in particular only two cases of anaphylaxis with erithromycin and clarithromycin have been reported to date. The aim of this study was to investigate macrolide-induced anaphylaxis. Between December 2007 and December 2011, 136 consecutive children were referred to the Allergy Unit of A. Meyer Children's Hospital because of a past history of reactions to macrolides. Allergy work-ups were carried out according to the European… 
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Azithromycin is more allergenic than clarithromycin in children with suspected hypersensitivity reaction to macrolides.

A complete allergy workup enabled us to confirm a diagnosis of clarithromycin and azithromyc allergy in 15.5% and 47.3% of cases, respectively.

Evaluation of Suspected Macrolide Allergies in Children

Drug skin tests are not capable of confirming or ruling out macrolide allergy, and oral provocation tests are essential for a definitive diagnosis.

Macrolide Allergy in Children and the Negative Predictive Value of Drug Provocation Tests in Mild Index Reactions

Confirmed macrolide allergy is rare in children, and DPTs are the gold standard to assess suspected macrolid allergy, and the NPV of macrolides provocation tests seems to be high in children.

Non–β-Lactam Antibiotic Hypersensitivity Reactions

Overall, 8 of 10 children with NBLA allergy could be delabeled, and timely access to allergy evaluation to delabel these patients is needed to preserve first-line antibiotics.

Hypersensitivity reactions to non‐betalactam antibiotics in children: An extensive review

  • S. KuyucuF. Mori K. Brockow
  • Medicine
    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
  • 2014
A standardized diagnostic approach and management strategy should be developed and employed for pediatric patients in the evaluation of suspected HSRs to NBLAs, some of which may be critical and unreplaceable in certain clinical situations.

Allergy to antibiotics in children: an overestimated problem.

Diagnostic Value of Oral Challenge Testing in the Diagnosis of Macrolide Hypersensitivity.

Epidemiology and drug allergy results in children investigated in allergy unit of a tertiary-care paediatric hospital setting

The study evaluated data related to a group of children with a positive history of drug reactions during a two-year period and demonstrated that only 9.1% of patients resulted in being positive to allergy tests which is in line with the data in literature.

Diagnosis and management of drug‐induced anaphylaxis in children: An EAACI position paper

There is a need for large, multicentric studies, to evaluate the real diagnostic value of the currently available skin tests to diagnose immediate reactions in children, and to develop new diagnostic tests in the future to improve the management of these children.

Management of antibiotic allergy in children: a practical approach

It is critical to avoid "labeling" a child as allergic without first conducting a proper diagnostic workup, and the best strategy for managing patients with sulfonamide hypersensitivity is an alternative antibiotic.

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