...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Allergy >Allergy to betalactam antibiotics in children: a prospective follow-up study in retreated children after negative responses in skin and challenge tests.
【24h】

Allergy to betalactam antibiotics in children: a prospective follow-up study in retreated children after negative responses in skin and challenge tests.

机译：儿童对β-内酰胺类抗生素的过敏：在皮肤和攻击试验中出现阴性反应后，对接受过治疗的儿童进行前瞻性随访研究。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: Up to 10% of the patients in whom suspected betalactam hypersensitivity (HS) has been excluded by skin and challenge tests report suspected allergic reactions during subsequent treatments with the same or very similar betalactams. It has been suggested that the reactions may result from a resensitization induced by the challenge performed at the time of the allergological work-up. However, most patients did not undergo a second allergological work-up, to determine if the reactions resulted from betalactam HS or not. OBJECTIVES: We aimed to determine if children diagnosed nonallergic to betalactams have tolerated subsequent treatments with the initially suspected and/or other betalactams, and, in case of a reaction, if the reaction resulted from betalactam HS. Methods: We sent a questionnaire concerning the clinical history of their children to the parents of 256 children previously diagnosed nonallergic to betalactams. A second allergological work-up was performed in the children reporting suspected allergic reactions during subsequent treatments with the same and/or other betalactams. Skin tests were performed with the soluble form of the suspected (or very similar) betalactams and other betalactams from the same and other classes. Skin test responses were assessed at 15-20 min (immediate), 6-8 h (semi-late) and 48-72 h (late). Oral challenge (OC) was performed in children with negative skin tests, either at the hospital (immediate and accelerated reactions), or at home (delayed reactions). RESULTS: A response was obtained from 141 children (55.3%). Forty-eight (34%) of those children had not been treated with the betalactams for whom a diagnosis of allergy had been ruled out previously. Seven (7.5%) of the 93 children who had been treated again reported suspected allergic reactions. Skin tests and OC were performed in six of those children, and gave negative results in five children. In one child previously diagnosed nonallergic to amoxicillin associated with clavulanic acid, we diagnosed a delayed HS to clavulanic acid and a serum sickness-like disease to cefaclor. Thus, the frequency of reactions resulting from betalactam HS in children with negative skin and challenge tests is very low, and does not exceed 2.1% (2/93) if we consider that the child which refused a second allergological work-up is really allergic to betalactams. CONCLUSION: Our results in a very large number of children show that reactions presumed to result from betalactam HS are rare in children in whom the diagnosis of betalactam allergy has been ruled out previously. Moreover, they suggest that, as shown for the initial reactions, most of the reactions during subsequent treatments are rather a consequence of the infectious diseases for whom betalactams have been prescribed than a result of betalactam HS. Finally, they suggest that the risk of resensitization by OC is very low, and do not support the notion that skin testing should be repeated in children diagnosed nonallergic to betalactams.
机译：背景：高达10％的怀疑贝他酰胺超敏性（HS）被皮肤排除的患者，挑战试验报告称在随后的相同或非常相似的β-内酰胺类药物治疗期间出现过敏反应。已经提出，该反应可能是由于在变应性检查时进行的攻击引起的再敏化所致。但是，大多数患者没有进行第二次过敏检查，以确定反应是否是由β-内酰胺HS引起的。目的：我们的目的是确定被诊断对β-内酰胺类药物非过敏的儿童是否耐受最初怀疑的和/或其他β-内酰胺类药物的后续治疗，如果出现反应，该反应是否由β-内酰胺类药物HS引起。方法：我们向256名先前被诊断对β-内酰胺类药物无过敏的儿童的父母发送了一份有关其儿童临床病史的调查表。在报告称在随后用相同和/或其他β-内酰胺类药物治疗期间出现疑似过敏反应的儿童中进行了第二次过敏学检查。用可溶形式的可疑（或非常相似）的β-内酰胺和其他相同或其他类别的β-内酰胺进行皮肤测试。在15-20分钟（立即），6-8小时（半晚）和48-72小时（晚）评估皮肤测试反应。对皮肤测试阴性的儿童进行口服挑战（OC），无论是在医院（即时反应和加速反应）还是在家（反应迟缓）。结果：141名儿童（55.3％）获得了回应。这些儿童中有48（34％）名患者未曾接受过β-内酰胺类药物的治疗，此前已排除了对β-内酰胺类药物过敏的诊断。 93名再次接受治疗的儿童中有7名（7.5％）报告怀疑有过敏反应。在其中六个孩子中进行了皮肤测试和OC，在五个孩子中给出了阴性结果。在一个先前被诊断对阿魏西林与克拉维酸无过敏的儿童中，我们诊断为克拉维酸延迟性HS和头孢克洛类血清病。因此，在皮肤和挑战测试阴性的儿童中，β-内酰胺HS引起的反应频率非常低，如果我们认为拒绝第二次过敏性检查的儿童确实是过敏的，则该频率不超过2.1％（2/93）到内酰胺。结论：我们在大量儿童中的研究结果表明，推测β-内酰胺HS引起的反应在先前已排除了β-内酰胺过敏诊断的儿童中很少见。此外，他们建议，如最初反应所示，在随后的治疗期间，大多数反应是β-内酰胺类药物所致的传染病的结果，而不是β-内酰胺类HS的结果。最后，他们认为OC重新致敏的风险非常低，并且不支持在诊断为对β内酰胺类非过敏的儿童中应重复皮肤测试的观点。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号