Key Message
Beta-lactams are the first-line antibiotic to control many bacterial
infections. Traditionally, the most frequently prescribed antibiotic in
children has been amoxicillin, which has been increasingly combined with
clavulanic acid. An accurate diagnosis is essential for avoiding the
prescription of alternative antibiotics which may be less effective,
more toxic. Betalactams drug hypersensitivity reactions are classified
as immediate and nonimmediate, being the last one the most frequent in
children. The aim of our study was to identify the drugs involved, the
selectivity of the response, the mechanism, and the value of the
different diagnostic tests for establishing a diagnosis in children
evaluated for DHRs to BLs. After the allergollogical study we conclude
that only few cases were confirmed of either type of reaction. Skin
testing proved less valuable in nonimmediate reactions, over half of
which would also have been lost in a short DPT protocol. Selective
responders to amoxicillin were more likely to have nonimmediate
reactions, while clavulanic acid-selectivity was exclusive to the
nonimmediate typology. Over half the cases with DPTs required 6-7 days
of treatment for DHR confirmation.