131:
Immediate selective hypersensitivity reaction to Clavulanic acid in Ukrainian children
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Vladyslava Barzylovych, PhD, Tetiana Umanets, PhD, Natalia Vakulenko, Fernando Pineda, PhD, Anastasia Barzylovych, PhD
RATIONALE:

Combination of Amoxicillin(AX) and clavulanic acid(CLV) is widely using in pediatrician practice in Ukraine. The statistics of amoxicillin allergy is forming only on anamnestic data and become unreasonably high. However, there are lack of reports with suspected CLV allergy.
The aim of our work was to confirm AX or CLV allergy in children who had history of suspected acute allergic reaction to amoxicillin+clavulanic acid.

METHODS:

Fifty six children (aged from 4 to 15) with suspected immediate hypersensitivity reaction to AX+CLV. Reported clinical symptoms were maculo-papular rash, urticaria/angioedema, bronchospasm which appeared within 30-60 minutes after AX+CLV intake.

Skin prick(SPT) and intradermal tests(IDT) were performed with DAP Amoxicillin (20mg/ml) and DAP Clavulanic (20mg/ml). Oral provocation tests(OPT) were done to children with negative SPT to AX with AX+CLV and AX within 14-days interval.

RESULTS:

Thirty four(60,7%) children had negative SPT, IDT and OPT both to AX and CLV.

Sixteen(28,5%) children had positive SPT to AX and 1(1,8%) child had positive SPT bouth with AX and CLV. Among 6(10,7%) children with positive SPT to CVL 5(8,9%) of them had positive OPT with AX+CLV, and all of them had negative OPT with AX.

CONCLUSIONS:

Skin and provocation tests allow to verify the diagnosis of drug allergy and should be widely used.

Immediate selective hypersensitivity reactions to CLV were found in around 10% of children with suspected immediate allergic reactions to AX+CLV combination.

It is reasonable to provide DAP Clavulanic during skin tests in children with suspected allergy to AX+CLV combination to reduce the unreasonable limitation of amoxicillin prescribing.