{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:09:47Z","timestamp":1788844187405,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non\u2010immediate drug hypersensitivity reactions (DHRs) in children are frequently overdiagnosed, leading to unnecessary drug avoidance. Evidence regarding predictors of more extensive reactions, drug provocation test (DPT) outcomes, and re\u2010exposure behavior and avoidance remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 161 children referred for suspected non\u2010immediate\u2010type DHRs. Clinical characteristics, reaction features, laboratory findings, and DPT outcomes were collected from medical records. Re\u2010exposure behavior and avoidance were assessed at 6 and 12\u2009months. Logistic regression was used to identify predictors of more extensive reactions, DPT outcomes, and avoidance of re\u2010exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Beta\u2010lactam antibiotics were the most frequently implicated drugs in 154 (95.7%) cases. Generalized cutaneous reactions occurred in 79 (49.1%) and were associated with male sex (OR: 2.70, 95% CI 1.31\u20135.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.007), concomitant rhinitis\/conjunctivitis (OR: 2.41, 1.02\u20135.71,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.045), atopic dermatitis (OR: 2.55, 1.05\u20136.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.038), and symptom onset after &gt;3.5\u2009days of treatment (OR: 3.21, 1.57\u20136.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.001). DPT was positive in 9.3% of tested children, with no independent predictors of positivity. A mild maculopapular rash as the index reaction independently predicted a negative DPT result. (OR: 6.74, 1.83\u201324.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.004). At 6\u2009months, 40.7% avoided re\u2010exposure despite clinical indication, associated with generalized urticaria as the index reaction (OR: 2.60, 1.00\u20136.72,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.048) and having received treatment for the reaction (OR: 4.12, 1.08\u201315.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.038). By 12\u2009months, 86.5% of patients had reused the culprit drug.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Male sex, atopic comorbidities, and later\u2010onset reactions were associated with an increased risk of more extensive non\u2010immediate\u2010type DHRs. Despite low DPT positivity and good re\u2010exposure tolerance, drug avoidance remains frequent, particularly after treated or generalized reactions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.70390","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T10:20:17Z","timestamp":1780914017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and behavioral determinants in pediatric non\u2010immediate drug hypersensitivity: Low confirmation but persistent avoidance"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4528-5404","authenticated-orcid":false,"given":"Ozge","family":"Can Bostan","sequence":"first","affiliation":[{"name":"School of Medicine, Department of Pulmonary Medicine, Division of Allergy and Clinical Immunology Marmara University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7444-251X","authenticated-orcid":false,"given":"Ozge","family":"Soyer","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Pediatric Allergy Hacettepe University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0976-5346","authenticated-orcid":false,"given":"Marios","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Department of Allergy and Respiratory Medicine Iaso Children's Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7584-5401","authenticated-orcid":false,"given":"Sophia","family":"Tsabouri","sequence":"additional","affiliation":[{"name":"Medical School, Child Health Department University of Ioannina  Ioannina 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