A Guide to Pediatric Antibiotic Allergy Testing
A Guide to Pediatric Antibiotic Allergy Testing
Rostrum, Journal of Allergy and Clinical Immunology: In Practice
Authors
John J.O. Accarino, MD ∙ Timothy G. Chow, MD ∙ Allison Ramsey, MD ∙ Christine R.F. Rukasin, MD ∙ Alexei Gonzalez-Estrada, MD ∙ Anne Y. Liu, MD ∙ David A. Khan, MD ∙ Kimberly G. Blumenthal, MD, MS and the US Drug Allergy Registry Study Team
Summary
Pediatric antibiotic labels are common, and unnecessary antibiotic avoidance is associated with negative personal and public health outcomes; as a result, there is an increasing emphasis on the importance of pediatric antibiotic allergy evaluations. Different testing strategies have been advised, including skin testing and challenge testing with varied doses and duration. Established consensus testing protocols are lacking. The US Drug Allergy Registry Pediatrics (USDAR-Peds) is a multisite prospective study designed for epidemiology and outcome evaluations of pediatric drug hypersensitivity reactions. Interpretation of multisite data requires a uniform clinical approach, and the USDAR-Peds standardized protocols were developed in response to this need. This rostrum aims to provide a rationale and framework for standardization for pediatric antibiotic allergy protocols and assessment of positive reactions through a pediatric-specific adaptation of the USDAR immediate reaction grading scale to create consistency for multisite research collaboration efforts such as USDAR-Peds.