Use of Meropenem in Children Labeled with Penicillin and Cephalosporin Allergy: A Retrospective Study Based on Reallife Data

Yıl 2025, Cilt: 25 Sayı: 3, 136 - 143, 31.10.2025

Merve Karaca Şahin , Güler Yıldırım , Nilay Çalışkan , Hamit Boloğur , Muhammed Fatih Erbay , Aslı Berivan Topçak , Hasan Tunç Şarman , Hilal Güngör , Çağla Öztürk , Şefika İlknur Kökçü Karadağ , Deniz Özçeker

https://doi.org/10.26650/jchild.2025.1725683

Öz

Objective: Beta-lactam antibiotics are among the most commonly used and frequently reported drug allergies. The beta-lactam ring has traditionally been considered to be responsible for cross-reactivity across all betalactam antibiotics. However, recent publications demonstrate that side chains, rather than the beta-lactam ring, are primarily responsible for cross-reactivity and that meropenem can be safely used in patients with beta-lactam allergies. The aim of our study was to evaluate the safety of meropenem in patients labeled with penicillin and cephalosporin allergies based on real-life data.

Materials and Methods: Children under the age of 18 years who were referred to the Pediatric Immunology and Allergy with a beta-lactam allergy label between January 1, 2017, and September 1, 2024, were retrospectively evaluated.

Results: A total of 95 children labeled with a beta-lactam allergy were referred to our Pediatric Allergy and Immunology Clinic for appropriate antibiotic selection. Among them, 64% were female and 36% were male. Fiftyeight patients were labeled as allergic to penicillins only, 31 to cephalosporins only, and 6 to both drug classes. Meropenem was administered to 23 patients. Of these, only three developed a rash following meropenem treatment and were re-referred for further evaluation. A total of 15 patients presented to our outpatient clinic for the diagnostic assessment of beta-lactam allergy. None of them had an allergy to meropenem. However, beta-lactam allergy was confirmed in three patients.

Conclusion: Meropenem appears to be a safe and effective alternative treatment option for patients labeled with beta-lactam allergy until a comprehensive beta-lactam allergy workup can be conducted.

Anahtar Kelimeler

Beta-lactam , Drug hypersensitivity , Meropenem , Cross-reactivity

Kaynakça

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