A Guide to Pediatric Antibiotic Allergy Testing: A Report From the US Drug Allergy Registry

Authors

John J. Accarino, Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass.
Timothy G. Chow, Division of Allergy and Immunology, Departments of Pediatrics and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Allison Ramsey, Rochester Regional HealthFollow
Christine R. Rukasin, Division of Allergy and Immunology, Phoenix Children's Hospital, Phoenix, Ariz; Division of Allergy, Asthma, and Immunology, Mayo Clinic Arizona, Scottsdale, Ariz.
Alexei Gonzalez-Estrada, Division of Allergy, Asthma, and Immunology, Mayo Clinic Arizona, Scottsdale, Ariz.
Anne Y. Liu, Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, and Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, Calif.
David A. Khan, Division of Allergy and Immunology, Departments of Pediatrics and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Kimberly G. Blumenthal, Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass.
US Drug Allergy Registry Study Team

Department

Allergy and Immunology

Document Type

Article

Publication Title

The Journal of Allergy and Clinical Immunology. In Practice

Abstract

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.

First Page

1018

Last Page

1026.e1

DOI

10.1016/j.jaip.2024.12.036

Volume

13

Issue

5

Publication Date

5-1-2025

Medical Subject Headings

Humans; Drug Hypersensitivity (diagnosis, epidemiology); Anti-Bacterial Agents (adverse effects, immunology); Registries; United States (epidemiology); Child; Skin Tests; Prospective Studies; Child, Preschool; Infant

PubMed ID

39755272

Recommended Citation

Accarino, J. J., Chow, T. G., Ramsey, A., Rukasin, C. R., Gonzalez-Estrada, A., Liu, A. Y., Khan, D. A., Blumenthal, K. G., & US Drug Allergy Registry Study Team. (2025). A Guide to Pediatric Antibiotic Allergy Testing: A Report From the US Drug Allergy Registry. The Journal of Allergy and Clinical Immunology. In Practice, 13 (5), 1018-1026.e1. https://doi.org/10.1016/j.jaip.2024.12.036