Evaluation of Children with Suspected Penicillin Allergy: A Single-Center Study

Öz

Objective: This study aimed to systematically evaluate pediatric patients referred with suspected penicillin allergy and determine the rate of confirmed penicillin allergy.

Materials and Methods: A retrospective study was conducted on 57 patients who presented to the Pediatric Allergy and Immunology Department of Istanbul Kanuni Sultan Süleyman Training and Research Hospital with suspected penicillin allergy between August 2023 and August 2025. All patients underwent specific IgE testing for amoxicillin, ampicillin, penicillin G, and penicillin V. Skin testing was performed in patients with parenteral drug reactions. Oral drug provocation testing was conducted in patients with negative specific IgE and skin tests.

Results: The mean age was 7.4±4.9 years (median: 6 years). The most common suspected drug was amoxicillin-clavulanate (77.2%). Urticaria/angioedema (61.4%) was the most frequent reaction type. Specific IgE positivity was detected in only 3 patients (5.3%). Drug provocation testing was performed in 53 patients, with 51 patients (96.2%) tolerating the drug without complications and 2 patients (3.8%) showing positive reactions. Penicillin allergy was confirmed in 6 patients (10.5%), whereas it was excluded (delabeled) in 51 patients (89.5%).

Conclusion: Our study demonstrated that 89.5% of penicillin allergy labels were incorrect. The low sensitivity of specific IgE testing was confirmed. Direct drug provocation testing is safe and effective in low-to-moderate-risk patients.

Anahtar Kelimeler

• Penicillin allergy
• Child
• Drug provocation test
• Delabeling
• Beta-lactam antibiotic
• Specific IgE

Kaynakça

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