Value of drug provocation test in non-immediate hypersensitivity reactions to betalactams in pediatric age.
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Ana Prieto, MD, PhD, Inmaculada Doña, MD, PhD, Candelaria Muñoz, MD, María Salas, MD, PhD, Esther Barrionuevo, MD, Phd, Maria J Torres, MD, PhD

Betalactams (BLs) are the most frequent cause of antibiotic hypersensitivity in children. The aim was to analyze the clinical characteristics and to determine the value of drug provocation test (DPT) as a diagnostic method without performing intradermal test previously in a group of children with non-immediate hypersensitivity reactions (NIHR) to BLs.


All children aged 1-14 years reporting NIHR to BLs from January to July 2017 were analyzed. Intradermal test was not performed. Diagnosis was confirmed by DPT, performed with a single dose followed by a 2 day/8 h course at maximum dose at home.


67 patients were included, 50% were male and the median age 5 years (IR:1-13). 44 (65%) had comorbidities: asthma, rhinoconjuntivitis and atopic dermatitis, being atopic dermatitis the most common. 40 (59%) had background family for atopy.

In a total of 44 cases (65,6%)amoxicillin was the culprit drug, in 22 (32.8%) amoxicillin-clavulanate and in 1 (1.5%) penicillin G. All patients took BLs for treating infectious diseases.The most usual symptoms were exanthema (46; 68,6%) cases, followed by urticaria (13; 19,4%) and urticaria-angiooedema (7; 10,4%). Only 6 (9%) patients were confirmed as being allergic, showing a delayed reaction during the the course given at home after DPT.


After an allergological work-up, over 90% of the children evaluated were finally confirmed as non-allergic to BLs. Since all the reactions were non-immediate and took place during the 2 day course, DPT could be performed with a single dose.