Purpose of review: In children, allergic reactions to antibiotic are rare and several recent publications confirmed that they are clearly overdiagnosed, representing a major public health problem. Highlighting the most recent literature, the present review addresses the management of children with a possible antibiotic allergy.
Recent findings: In diagnosis of antibiotic allergy, the patient's history is central although not sufficient. In case of suspicion of an allergy, the child should be referred to an allergist in order to perform a complete allergy workup, based on carefully selected diagnostic tests depending on whether an immediate or a nonimmediate reaction is suspected. The antigen challenge test remains the gold standard and has gained in importance, particularly in children presenting a benign rash while taking antibiotic treatment. However, this test potentially exposes individuals to a significant risk of severe reaction and has relevant cost and is time consuming. Several new diagnostic tools are currently under investigation and provide promising results.
Summary: Accurate diagnosis of antibiotic allergy is important not only to prevent serious or even life-threatening reactions, but also to avoid unnecessary drug restriction associated with increased resistance and health costs.