Sospecha de alergia a amoxicilina en urgencias pediátricas: baja confirmación diagnóstica y elevada tasa de cambios antibióticos inapropiados

IF 2.2 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica Pub Date : 2026-03-01 Epub Date: 2026-01-19 DOI:10.1016/j.eimc.2025.503077

Iciar Echavarren Churruca , Gabriela Milagros Acuña Vila , Carmen Gómez Traseira , Begoña de Miguel Lavisier , Miguel Ángel Molina Gutiérrez

{"title":"Sospecha de alergia a amoxicilina en urgencias pediátricas: baja confirmación diagnóstica y elevada tasa de cambios antibióticos inapropiados","authors":"Iciar Echavarren Churruca , Gabriela Milagros Acuña Vila , Carmen Gómez Traseira , Begoña de Miguel Lavisier , Miguel Ángel Molina Gutiérrez","doi":"10.1016/j.eimc.2025.503077","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Reactions to β-lactam antibiotics account for up to 80% of pediatric consultations for suspected drug allergy. This study aimed to describe the characteristics of children evaluated in the emergency department for suspected allergy to amoxicillin or amoxicillin-clavulanate.</div></div><div><h3>Materials and methods</h3><div>We conducted a descriptive, retrospective study in a tertiary hospital (January 2019-May 2024), including patients ≤16 years with a diagnosis of suspected allergy to these antibiotics.</div></div><div><h3>Results</h3><div>Eighty-two cases were analyzed; 93.9% presented with cutaneous lesions and none showed hemodynamic instability. Two patients received intramuscular epinephrine for immediate reactions consistent with mild anaphylaxis. Antibiotic treatment was discontinued in 95.1% of cases, and 54.7% of the substitutions were considered inappropriate. A total of 69.5% were referred to Allergy, and only 7patients (12.3%) were confirmed to have true amoxicillin allergy.</div></div><div><h3>Conclusions</h3><div>Suspected amoxicillin allergy in pediatric emergency care generally has a favorable prognosis. The low diagnostic confirmation rate and frequent inappropriate antibiotic changes highlight the need to improve adherence to clinical guidelines.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 3","pages":"Article 503077"},"PeriodicalIF":2.2000,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Enfermedades infecciosas y microbiologia clinica","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0213005X25002915","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/19 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Reactions to β-lactam antibiotics account for up to 80% of pediatric consultations for suspected drug allergy. This study aimed to describe the characteristics of children evaluated in the emergency department for suspected allergy to amoxicillin or amoxicillin-clavulanate.

Materials and methods

We conducted a descriptive, retrospective study in a tertiary hospital (January 2019-May 2024), including patients ≤16 years with a diagnosis of suspected allergy to these antibiotics.

Results

Eighty-two cases were analyzed; 93.9% presented with cutaneous lesions and none showed hemodynamic instability. Two patients received intramuscular epinephrine for immediate reactions consistent with mild anaphylaxis. Antibiotic treatment was discontinued in 95.1% of cases, and 54.7% of the substitutions were considered inappropriate. A total of 69.5% were referred to Allergy, and only 7 patients (12.3%) were confirmed to have true amoxicillin allergy.

Conclusions

Suspected amoxicillin allergy in pediatric emergency care generally has a favorable prognosis. The low diagnostic confirmation rate and frequent inappropriate antibiotic changes highlight the need to improve adherence to clinical guidelines.

查看原文本刊更多论文

儿科急诊中疑似阿莫西林过敏：诊断确认率低，抗生素不适当改变率高

对β-内酰胺类抗生素的反应占儿科疑似药物过敏咨询的80%。本研究旨在描述在急诊科因疑似阿莫西林或阿莫西林-克拉维酸酯过敏而接受评估的儿童的特征。材料与方法我们在一家三级医院（2019年1月- 2024年5月）进行了一项描述性回顾性研究，纳入了≤16岁、诊断为疑似对这些抗生素过敏的患者。结果共分析病例82例；93.9%表现为皮肤病变，无血流动力学不稳定。2例患者接受肌注肾上腺素治疗，立即出现轻度过敏反应。95.1%的病例停止抗生素治疗，54.7%的替代被认为不合适。69.5%的患者被转诊为过敏，只有7例患者（12.3%）被确认为真正的阿莫西林过敏。结论小儿急诊疑似阿莫西林过敏患者预后良好。低诊断确认率和频繁不适当的抗生素更换突出了提高临床指南依从性的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Enfermedades infecciosas y microbiologia clinica 医学-传染病学

CiteScore

2.10

自引率

8.00%

发文量

194

审稿时长

29 days

期刊介绍： Hoy está universalmente reconocida la renovada y creciente importancia de la patología infecciosa: aparición de nuevos agentes patógenos, de cepas resistentes, de procesos con expresión clínica hasta ahora desconocida, de cuadros de una gran complejidad. Paralelamente, la Microbiología y la Infectología Clínicas han experimentado un gran desarrollo como respuesta al reto planteado por la actual patología infecciosa. Enfermedades Infecciosas y Microbiología Clínica es la Publicación Oficial de la Sociedad Española SEIMC. Cumple con la garantía científica de esta Sociedad, la doble función de difundir trabajos de investigación, tanto clínicos como microbiológicos, referidos a la patología infecciosa, y contribuye a la formación continuada de los interesados en aquella patología mediante artículos orientados a ese fin y elaborados por autores de la mayor calificación invitados por la revista.