Immediate reactions
Diagnosis of IR was established in 11 of the 133 cases evaluated (8.3%), nearly three-quarters (72.7%) of whom were girls. Reactions were induced by AX (72.7%), AX-CLAV (18.2%), and cephalosporins (9.1%).
SIgE was detected in two cases. One patient presented values of sIgE to AX of 0.37 kU/l; to ampicillin, 0.37 kU/l; to PG, 0.36 kU/l; and to PV, 0.35 kU/l. Another showed sIgE to AX of 0.52kU/l; to ampicillin, 0.49kU/l; to PG, 0.37 kU/l; and to PV, 0.35 kU/l.
Different ST were positive in 4 out of 131 children, all to AX: by prick test at 20 mg/ml (n = 1), intradermal test at 2 mg/ml (n = 1), and intradermal test at 20 mg/ml (n = 2).
DPTs were performed in the remaining 127 patients, yielding positive results in 5 (Table 1), in all cases within 45 minutes or less. Three cases were positive to AX but showed good tolerance to PG and PV; one case was positive to PV; and one to cefaclor. Most of the reactions observed during the DPT were mild (urticaria in 1 case and angioedema in 3 cases), with only one child developing skin involvement plus bronchospasm and good recovery after treatment. The remaining 122 cases presented good tolerance to AX or another culprit BL until reaching therapeutic doses.
Is summary, of the total 8.3 % positives cases within this group SIgE contributed to the diagnosis in the 1.5%, ST with all the determinants in the 3% and DPT in the 3.7%. Selective reactions occurred with AX (63%), followed by common penicillin determinants (27%) and cephalosporins (0.9%).