Abstract
About 10-15% patients report allergy to antibiotics in their medical history. The diagnosis is usually incorrect, it is often overused and, as a result, may harm patients by treatment with alternative antibiotics.
Epidemiological data in the Czech Republic are not known. This study evaluated 611 patients attending a regional paediatric allergy clinic for reported allergy to beta-lactam antibiotics, focusing on immediate reactions.
Delayed skin eruptions following antibiotic treatment in children are the most frequently reported reactions a are usually benign. These delayed reactions were reported by 85% of our patients, immediate reactions were reported by 10% of patients.
The diagnosis of a drug allergy was confirmed more frequently (29%) in this cohort describing immediate reactions when compared with the total group (13%). The most common reported symptoms of immediate reactions were skin manifestations - urticaria and angioedema (88,5%), followed by anaphylaxis (5%), non-specific symptoms (5%) and tongue oedema (1,6%).
The diagnostic workup included of medical history, skin tests, laboratory tests and drug challenge where necessary. Drug challenge either confirmed the diagnosis of the suspected drug allergy or safe tolerance of an alternative antibiotic. "Red flags" of immediate reactions or severe delayed reactions should not be overlooked regardless of age of the patient.