Suspicious drug hypersensitivity reactions in pediatric patients: a retrospective single-center study

Abstract

Drug hypersensitivity reactions (DHRs) are important clinical problems in childhood. There have been only a limited number of studies conducted in Turkey on this subject. This study was performed to obtain knowledge about DHRs in pediatric patients. Therefore, this study assesses the properties of hypersensitivity reactions, culprit drugs, patient risk factors, and common errors related to the management of these reactions. The study was conducted as a retrospective cross-sectional study by an assessment of data from 96 patients with DHRs evaluated in our department between December 2009 and August 2011. Information was obtained on prevalence of the DHRs, type and properties of the reactions, culprit drugs, patient characteristics, and the management of the reactions. The total prevalence of DHRs was 0.47%. The prevalence of DHRs was 0.38 and 0.50% in inpatients and outpatients, respectively, while the prevalence of DHRs requiring hospitalization of outpatients was 0.1%. The drugs most commonly causing hypersensitivity reactions were β-lactam antibiotics (80.3%). The skin was the most common system involved in DHRs, and maculopapular rashes were the most common type of skin involvement (40.5%). Anaphylaxis was the most common severe DHR. Of the five patients with identified anaphylaxis, only two received epinephrine. β-Lactam antibiotics were the most common causative agent in this study. Therefore, the rationale use of antibiotics for infections commonly encountered in childhood is important. Physicians’ levels of knowledge about the recognition of anaphylaxis and the management of severe reactions should be increased. It is important to evaluate patients who have a history of previous DHRs and/or asthma in order to prevent future DHRs. It is necessary to educate doctors about the administration of epinephrine as the most important part of the treatment of anaphylaxis.