{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:02:29Z","timestamp":1790190149982,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Clarithromycin hypersensitivity is reported as the most common cause of non\u2010\u03b2\u2010lactam antibiotic allergy in children. Clarithromycin is frequently prescribed in cases of suspected \u03b2\u2010lactam hypersensitivity. Oral provocation tests stand as the gold standard to confirm drug hypersensitivity as diagnostic value of skin tests is variable. We analyzed the frequency of true clarithromycin hypersensitivity ratio and its relationship with \u03b2\u2010lactam allergy among children with suspected clarithromycin hypersensitivity and evaluated the diagnostic value of skin tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included 160 children referred with suspected clarithromycin hypersensitivity. Clinical history and allergy workups including skin tests or\/and oral provocation tests were retrieved from medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Oral provocation test confirmed clarithromycin hypersensitivity rate was 5.6% (<jats:italic>n<\/jats:italic>\u00a0=\u00a09\/160). Skin tests with clarithromycin showed positivity in 32.6% (<jats:italic>n<\/jats:italic>\u00a0=\u00a029\/89) of the tested patients. The sensitivity of clarithromycin skin tests was negligible, and specificity was 73.9% (95% confidence interval [CI], 64.7\u201381.8). Eighty\u2010eight of the patients (55%) reported that they had previously tolerated a \u03b2\u2010lactam antibiotic. \u03b2\u2010lactam hypersensitivity was suspected in 40% (<jats:italic>n<\/jats:italic>\u00a0=\u00a064\/160) of the patients (simultaneous [<jats:italic>n<\/jats:italic>\u00a0=\u00a010], sequential [<jats:italic>n<\/jats:italic>\u00a0=\u00a019], distant form [<jats:italic>n<\/jats:italic>\u00a0=\u00a035]) in relation with clarithromycin usage. \u03b2\u2010lactam hypersensitivity (95% CI, 2.1\u201370.6,<jats:italic>p<\/jats:italic>\u00a0=\u00a0.005) and sequential usage of clarithromycin after the development of a rash with amoxicillin\u2010clavulanic acid (95% CI, 2.0\u201396.4,<jats:italic>p<\/jats:italic>\u00a0=\u00a0.007) were found as risk factors for confirmed clarithromycin hypersensitivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The frequency of confirmed clarithromycin hypersensitivity was found low among suspected patients. Oral provocation test is crucial for definite diagnosis. Confirmed \u03b2\u2010lactam allergy may be attributed as a risk factor for clarithromycin hypersensitivity, particularly clarithromycin treatment after a developing rash with amoxicillin\u2010clavulanic acid in sequential usage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pai.13588","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T19:27:23Z","timestamp":1624908443000},"page":"1781-1787","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clarithromycin hypersensitivity in children: Is there a link with \u03b2\u2010lactam hypersensitivity?"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9190-6849","authenticated-orcid":false,"given":"Ayse","family":"Suleyman","sequence":"first","affiliation":[{"name":"Division of Pediatric Allergy and Immunology Department of Pediatrics Istanbul Faculty of Medicine Istanbul University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3712-2522","authenticated-orcid":false,"given":"Esra","family":"Yucel","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy and Immunology Department of Pediatrics Istanbul Faculty of Medicine Istanbul University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3026-0906","authenticated-orcid":false,"given":"Sevgi","family":"Sipahi Cimen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy and Immunology Department of Pediatrics Istanbul Faculty of Medicine Istanbul University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6159-9895","authenticated-orcid":false,"given":"Zeynep","family":"Hizli Demirkale","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy and Immunology Department of Pediatrics Istanbul Faculty of Medicine Istanbul University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9284-4520","authenticated-orcid":false,"given":"Cevdet","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy and Immunology Department of Pediatrics Istanbul Faculty of Medicine Istanbul University Istanbul Turkey"},{"name":"Department of Pediatric Basic Sciences Institute of Child Health Istanbul University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3200-5493","authenticated-orcid":false,"given":"Zeynep Ulker","family":"Tamay","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy and Immunology Department of Pediatrics Istanbul Faculty of Medicine Istanbul University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9702-0491","authenticated-orcid":false,"given":"Nermin","family":"Guler","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy and Immunology Department of Pediatrics Istanbul Faculty of Medicine Istanbul University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2174\/138161208786369812"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000443830"},{"issue":"6","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1111\/pai.12273","article-title":"Hypersensitivity reactions to non\u2010betalactam antibiotics in children: an extensive review","volume":"25","author":"Kuyucu S","year":"2014","journal-title":"Pediatr Allergy 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