Beta-lactam hypersensitivity in children with cystic fibrosis: a study in a specialized pediatric center for cystic fibrosis and drug allergy
Version of Record online: 18 NOV 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Pediatric Allergy and Immunology
Volume 25, Issue 1, pages 88–93, February 2014
How to Cite
Beta-lactam hypersensitivity in children with cystic fibrosis: a study in a specialized pediatric center for cystic fibrosis and drug allergy. Pediatr Allergy Immunol 2014: 25: 88–93., , , , .
- Issue online: 19 FEB 2014
- Version of Record online: 18 NOV 2013
- Manuscript Accepted: 26 SEP 2013
- beta-lactam hypersensitivity;
- challenge tests;
- cystic fibrosis;
- skin tests
Beta-lactam hypersensitivity (HS) is suspected in 5–12% of the children, but proven in only 10–15% of those children, based on skin and challenge tests results. In contrast, 30–60% of patients with cystic fibrosis (CF) are diagnosed allergic to beta-lactams, based mainly on the clinical history of the patients.
To confirm or rule out a suspected beta-lactam HS in CF children and to determine the prevalences of suspected and confirmed beta-lactam HS in those children.
Patients and methods
Children with CF and suspected beta-lactam HS were explored by means of skin and challenge tests with the suspected and alternate beta-lactams. The results in CF children were compared with those reported in the literature in non- CF children.
Eight of the 701 CF children followed in our center between 1990 and 2011 (1.14%), and 11 other children from other centers were explored for suspected beta-lactam HS. Beta-lactam HS was diagnosed in nine of these children (47.3%). Based on the results in the children followed in our center, the prevalence of beta-lactam HS was 0.71% (5/701) in CF children vs. a mean estimated prevalence of 1–1.5% in the general pediatric population.
Our results contrast with those of most previous studies. Although half of the CF children with suspected beta-lactam HS were truly allergic to beta-lactams, the general prevalence of beta-lactam HS in CF children was very low. This may result from tolerance induced by frequent and/or prolonged treatments with beta-lactams.