Researchers determined that the most common antibiotic allergy in children with cystic fibrosis (CF) is an allergy to beta-lactams and published their findings in Pediatric Pulmonology.

They noted that, unlike healthy children, children with CF are more likely to be allergic to ceftazidime and piperacillin-tazobactam.

“In CF patients with suspected antibiotic hypersensitivity reactions, a comprehensive allergy assessment (detailed history, skin, and provocation test) is critical to determine the culprit drug in order to identify a safe alternative antibiotic,” the authors said.

“This study aimed to identify the patterns and risk factors of proven antibiotic allergy in CF patients.”

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The research team conducted a case-control study on 240 children with a confirmed diagnosis of CF from a single center in Istanbul, Turkey between May 2008 and September 2021. Fifteen of these patients with complete data were included in the analysis, along with control children with CF who were assessed for drug allergies but were found to be tolerant.

For each patient, there were 3 gender- and age-matched controls. Detailed information about their suspected drug allergies was collected, along with demographic data, previous drug reactions, family allergy history, hospitalizations, and CF diagnosis and follow-up data.

The results of the analysis revealed that multiple drug allergies were common in these patients, and the most common antibiotic allergy was to beta-lactam drugs, in particular ceftazidime and piperacillin-tazobactam. In terms of non-beta-lactam antibiotics, ciprofloxacin was the leading culprit in patients with CF. None of these agents are commonly used in children without CF.

The team also found that a history of an immediate drug reaction significantly predicted an allergy to that drug; therefore, they recommend an allergic evaluation within 6 months after a reaction for an accurate diagnosis.

Reference

Süleyman A, Tamay Z, Güler N. Antibiotic allergy in children with cystic fibrosis: a retrospective case–control study. Pediatr Pulmonol. Published online July 14, 2022. doi:10.1002/ppul.26073