Öz

Objective: The aim of this study was determine the rate of confirmed drug allergy using a stepwise diagnostic algorithm in children with a suspected or previously labeled drug allergy, to assess the proportion of patients in whom an incorrect drug- allergy label could be safely removed (delabeling rate), and to evaluate the diagnostic tests applied.

Materials and Methods: In this retrospective cross-sectional study, children presenting with suspected drug allergy to our pediatric allergy clinic between April 2023 and January 2025 were evaluated retrospectively. A stepwise protocol comprising detailed history, drug-specific IgE, skin tests (prick and intradermal), and drug provocation testing (oral or, when clinically indicated, subcutaneous or intravenous) was applied. Of 127 patients initially assessed, 41 were excluded and 86 who completed the clinically indicated diagnostic evaluation were analyzed.

Results: The mean age was 10.5±4.6 years. True drug allergy was confirmed in 16 patients (18.6%), whereas the incorrect drug-allergy label was safely removed in 70 (81.4%). Beta-lactams were the most common culprit group (12/16; 75.0%). Parental atopy, parental drug allergy, and personal atopy were significantly more frequent in the true-allergy group (p=0.004, p=0.028, and p=0.006, respectively), whereas no significant difference was found for age, sex, or laboratory parameters. In 10 confirmed patients, the diagnosis was established only by OPT. Anaphylaxis occurred in two of the 74 OPTs performed (2.7% per test).

Conclusion: In the majority of children presenting with suspected drug allergy, true allergy can be safely excluded through comprehensive diagnostic evaluation. Under appropriate patient selection and safe conditions, OPT is the gold-standard method for confirming or excluding true drug allergy, while specific IgE and skin tests support a stepwise evaluation for selected drugs; referral of these children to a pediatric allergist is important for both individual patient safety and antimicrobial stewardship.

Anahtar Kelimeler: Anti-bacterial agents, beta-lactams, child, drug hypersensitivity, immunoglobulin E, skin tests

Kaynakça

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Nasıl atıf yapılır

1.
Kaya MŞ, Sefer AP. How many suspected drug allergies in children are true allergies? A stepwise diagnostic evaluation from a single center. Turk J Pediatr Dis. 2026;20(6):442-448. https://doi.org/10.12956/TJPD.2026.1397