Retrospective Examınatıon of Children with Beta Lactam-Drug Allergy: A Single-Center Experience

Objective: The occurrence of drug reactions due to IgE or T-cell-mediated hypersensitivity reactions is referred to as drug allergy. Beta-lactam antibiotic (BLA) is the most common cause of drug allergy. In our study, we aimed to determine the true frequency of allergy in patients who presented to the children's immunology and allergy polyclinic on suspicion of BLA allergy and performed drug provocation test (DPT) and to evaluate the clinical, demographic, and laboratory characteristics of these patients. Methods: Between 2017 and 2023, 141 patients (75 immediate reaction and 66 non immediate reaction) aged 0-18 years who applied to our hospital's pediatric immunology and allergy outpatient clinic with suspicion of BLA allergy and underwent DPT were included. Retrospective records from the last 6 years were examined from hospital data; age (month), sex, history of concomitant chronic diseases, history of additional allergic diseases, history of drug allergies in the family, type of reaction, serum total IgE, percentage of eosinophils (%), history of BLA use (penicillin V, penicillin G, ampicillin, amoxicillin etc.), specific IgE values, and drug intradermal test (IDT) results were recorded. Results: In our study, 141 patients aged between 0 and 18 years were evaluated. 33 (23.4%) of them were IDT-positive. DPT was not performed because 24 patients did not have family permission and 9 patients experienced anaphylaxis. In our study, the BLA allergy rate determined by and/or skin tests was 26.9%, whereas the frequency of BLA allergy confirmed by DPT was 5.6%. Conclusions: Beta lactam antibiotics are widely used worldwide and are the most common cause of drug-induced allergic reactions. Diagnosing a drug allergy thought to be associated with BLA based on history alone leads to the unnecessary use of broad-spectrum antibiotics and, consequently, to the development of antibiotic resistance. The patients should be referred to the child allergy department to be able to be definitively diagnosed for patients with suspected BLA drug allergy. Thus, we hope that unnecessary broad-spectrum antibiotics will be prescribed and that the use of expensive drugs will be prevented.