Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/33994
Title: Assessing Pediatric Cephalosporin Allergic Reactions Through Direct Graded Oral Challenges.
Austin Authors: Sillcox, Carly;Gabrielli, Sofianne;O'Keefe, Andrew;McCusker, Christine;Abrams, Elissa M;Eiwegger, Thomas;Atkinson, Adelle;Kim, Vy;Copaescu, Ana-Maria;Ben-Shoshan, Moshe
Affiliation: Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Department of Pediatrics, Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, Canada.
Division of Allergy and Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria; Department of Pediatric and Adolescent Medicine, University Hospital St. Pölten, St. Pölten, Austria; Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada; Department of Immunology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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Medicine (University of Melbourne)
Division of Allergy and Clinical Immunology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
Issue Date: Jan-2024
Date: 2023
Publication information: The journal of Allergy and Clinical Immunology. In Practice 2024-01; 12(1)
Abstract: Cephalosporins, beta-lactam antibiotics, commonly cause allergic reactions. To assess the clinical characteristics and management of pediatric patients with suspected cephalosporin allergy using direct graded oral challenges (GOCs). Children referred for suspected cephalosporin allergy at four Canadian clinics were recruited over 10 years. Data on demographics, clinical reaction characteristics, and management were collected through a questionnaire. Patients underwent a direct GOC (initially 10% of the treatment dose, then 90% after 20 minutes), and reactions were monitored one-week post-challenge. Families were contacted annually for up to five years to detect subsequent antibiotic reactions. Logistic regression analysis identified factors associated with positive GOC reactions. Among the 136 patients reporting cephalosporin allergy, 75 (55.1%) were males with a median age of 3.9 years (IQR, 2.3 to 8.7). Cefprozil represented the most common cephalosporin linked to the index reaction (67.6% of cases). Of the 136 direct GOCs, 5.1% had an immediate and 4.4% non-immediate reaction, respectively. Positive GOCs conducted in children with a history of skin-limited non-severe rashes were classified as mild, benign skin rashes. Positive GOCs were more likely in children with food allergies [adjusted Odds Ratio (aOR) 1.14 (95% CI 1.00, 1.29)]. Direct GOCs are safe and effective for diagnosing pediatric cases who report non-vesicular skin-limited symptoms while treated with cephalosporins.
URI: https://ahro.austin.org.au/austinjspui/handle/1/33994
DOI: 10.1016/j.jaip.2023.10.009
ORCID: 
Journal: The journal of Allergy and Clinical Immunology. In Practice
PubMed URL: 37832819
ISSN: 2213-2201
Type: Journal Article
Subjects: allergy
antibiotic
cephalosporin
pediatric
Appears in Collections:Journal articles

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