Delabelling Antibiotic Hypersensitivity in Children Is Critical for Future Treatments

Purpose of Review: Antibiotics are most commonly prescribed drugs in children; among them, beta-lactams are the most frequently used antibiotics. Antibiotic allergy mislabelling is a considerable public health problem which is associated with adverse health and economic outcomes. In this review, the actual antibiotic allergy prevalence, the reasons for overdiagnosis, and the consequences of mislabelling are summarized. Recent Findings: The physicians should consider the use of drug provocation tests without prior skin testing in the cases of non-immediate mild cutaneous reactions due to antibiotics as proposed by Pediatric Drug Allergy Task Force of European Academy of Allergy and Clinical Immunology. Mild cutaneous eruptions are quite common in children during viral infections which create a diagnostic challenge. This approach may decrease the time and effort during testing, increase the utility of diagnostic evaluation, and thereby contribute to lessen the ratio of mislabelling as drug hypersensitive. Summary: Antibiotic allergy is often overestimated and not accurately diagnosed during childhood. Delabelling antibiotic hypersensitivity is crucial for appropriate management of children because of serious health consequences and economic burden. Alternative antibiotics have broader spectrum leading to development of resistant bacterial infections, have more adverse effects and higher costs, and are usually second line that might be less effective option. A detailed assessment of child with a history of antibiotic hypersensitivity reaction benefits the child, the community, and the healthcare system.