{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T13:10:35Z","timestamp":1792242635673,"version":"4.4.0"},"reference-count":19,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Penicillin allergy is commonly reported in the pediatric emergency department (ED). True penicillin allergy is rare, yet the diagnosis results from the denial of first-line antibiotics. We hypothesize that all children presenting to the pediatric ED with symptoms deemed to be low-risk for immunoglobulin E-mediated hypersensitivity will return negative results for true penicillin allergy.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Parents of children aged 4 to 18 years old presenting to the pediatric ED with a history of parent-reported penicillin allergy completed an allergy questionnaire. A prespecified 100 children categorized as low-risk on the basis of reported symptoms completed penicillin allergy testing by using a standard 3-tier testing process. The percent of children with negative allergy testing results was calculated with a 95% confidence interval.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Five hundred ninety-seven parents completed the questionnaire describing their child\u2019s reported allergy symptoms. Three hundred two (51%) children had low-risk symptoms and were eligible for testing. Of those, 100 children were tested for penicillin allergy. The median (interquartile range) age at testing was 9 years (5\u201312). The median (interquartile range) age at allergy diagnosis was 1 year (9 months\u20133 years). Rash (97 [97%]) and itching (63 [63%]) were the most commonly reported allergy symptoms. Overall, 100 children (100%; 95% confidence interval 96.4%\u2013100%) were found to have negative results for penicillin allergy and had their labeled penicillin allergy removed from their medical record.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>All children categorized as low-risk by our penicillin allergy questionnaire were found to have negative results for true penicillin allergy. The utilization of this questionnaire in the pediatric ED may facilitate increased use of first-line penicillin antibiotics.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2017-0471","type":"journal-article","created":{"date-parts":[[2017,7,3]],"date-time":"2017-07-03T09:10:11Z","timestamp":1499073011000},"source":"Crossref","is-referenced-by-count":119,"title":["Allergy Testing in Children With Low-Risk Penicillin Allergy Symptoms"],"prefix":"10.1542","volume":"140","author":[{"given":"David","family":"Vyles","sequence":"first","affiliation":[{"name":"Pediatric Emergency Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Adams","sequence":"additional","affiliation":[{"name":"Asthma\/Allergy and Clinical Immunology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asriani","family":"Chiu","sequence":"additional","affiliation":[{"name":"Asthma\/Allergy and Clinical Immunology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pippa","family":"Simpson","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Nimmer","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Brousseau","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2017,8,1]]},"reference":[{"issue":"4","key":"2021121113061528500_B1","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/S0889-8561(05)70036-9","article-title":"Adverse reactions to \u03b2-lactam antibiotics.","volume":"18","author":"Mendelson","year":"1998","journal-title":"Immunol Allergy Clin"},{"key":"2021121113061528500_B2","first-page":"S498","article-title":"\u03b2-Lactam antibiotics: the diagnosis and management of anaphylaxis.","volume":"101","author":"Nicklas","year":"1999","journal-title":"J Allergy Clin Immunol"},{"issue":"6784","key":"2021121113061528500_B3","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1136\/bmj.302.6784.1051","article-title":"Allergy to penicillin: fable or fact?","volume":"302","author":"Surtees","year":"1991","journal-title":"BMJ"},{"issue":"1","key":"2021121113061528500_B4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/j.1742-1241.1994.tb09729.x","article-title":"Penicillin allergy: a study of incidence as reported by patients.","volume":"48","author":"Kerr","year":"1994","journal-title":"Br J Clin Pract"},{"issue":"3","key":"2021121113061528500_B5","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.1398-9995.1984.tb02619.x","article-title":"Penicillin allergy\u2013can the incidence be reduced?","volume":"39","author":"Ahlstedt","year":"1984","journal-title":"Allergy"},{"issue":"18","key":"2021121113061528500_B6","doi-asserted-by":"crossref","first-page":"2819","DOI":"10.1001\/archinte.160.18.2819","article-title":"The incidence of antimicrobial allergies in hospitalized patients: implications regarding prescribing patterns and emerging bacterial resistance.","volume":"160","author":"Lee","year":"2000","journal-title":"Arch Intern Med"},{"issue":"3","key":"2021121113061528500_B7","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.acap.2016.11.004","article-title":"Parent-reported penicillin allergy symptoms in the pediatric emergency department.","volume":"17","author":"Vyles","year":"2017","journal-title":"Acad Pediatr"},{"issue":"1","key":"2021121113061528500_B8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4103\/2231-4040.70513","article-title":"The facts about penicillin allergy: a review.","volume":"1","author":"Bhattacharya","year":"2010","journal-title":"J Adv Pharm Technol Res"},{"issue":"8","key":"2021121113061528500_B9","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1592\/phco.31.8.736","article-title":"Assessment of the validity of reported antibiotic allergic reactions in pediatric patients.","volume":"31","author":"Miller","year":"2011","journal-title":"Pharmacotherapy"},{"issue":"6","key":"2021121113061528500_B10","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1007\/s11882-012-0303-2","article-title":"Viral-bacterial interactions in acute otitis media.","volume":"12","author":"Marom","year":"2012","journal-title":"Curr Allergy Asthma Rep"},{"key":"2021121113061528500_B11","unstructured":"Centers for Disease Control and Prevention . Management of persons who have a history of penicillin allergy. Available at: https:\/\/www.cdc.gov\/std\/treatment\/2010\/penicillin-allergy.htm. Accessed September 30, 2016"},{"issue":"1","key":"2021121113061528500_B12","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.annemergmed.2008.12.034","article-title":"The use of penicillin skin testing to assess the prevalence of penicillin allergy in an emergency department setting.","volume":"54","author":"Raja","year":"2009","journal-title":"Ann Emerg Med"},{"issue":"6","key":"2021121113061528500_B13","doi-asserted-by":"crossref","first-page":"e160033","DOI":"10.1001\/jamapediatrics.2016.0033","article-title":"Assessing the diagnostic properties of a graded oral provocation challenge for the diagnosis of immediate and nonimmediate reactions to amoxicillin in children.","volume":"170","author":"Mill","year":"2016","journal-title":"JAMA Pediatr"},{"issue":"3","key":"2021121113061528500_B14","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.jaip.2014.11.002","article-title":"Improving the effectiveness of penicillin allergy de-labeling.","volume":"3","author":"Bourke","year":"2015","journal-title":"J Allergy Clin Immunol Pract"},{"issue":"1","key":"2021121113061528500_B15","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S1081-1206(10)60402-4","article-title":"Skin testing and oral penicillin challenge in patients with a history of remote penicillin allergy.","volume":"100","author":"Goldberg","year":"2008","journal-title":"Ann Allergy Asthma Immunol"},{"issue":"1","key":"2021121113061528500_B16","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.jaci.2010.08.025","article-title":"The role of penicillin in benign skin rashes in childhood: a prospective study based on drug rechallenge.","volume":"127","author":"Caubet","year":"2011","journal-title":"J Allergy Clin Immunol"},{"issue":"4","key":"2021121113061528500_B17","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1089\/088318700750070439","article-title":"Anaphylaxis to benzathine penicillin G.","volume":"14","author":"Napoli","year":"2000","journal-title":"Pediatr Asthma Allergy Immunol"},{"issue":"8753","key":"2021121113061528500_B18","first-page":"1308","article-title":"Allergic reactions to long-term benzathine penicillin prophylaxis for rheumatic fever.","volume":"337","author":"International Rheumatic Fever Study Group","year":"1991","journal-title":"Lancet"},{"key":"2021121113061528500_B19","first-page":"168","volume-title":"Current Problems in Dermatology. Antibiotic Treatment of Venereal Diseases","author":"Ids\u00f8e","year":"1968"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2017-0471\/1064609\/peds_20170471.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2017-0471\/1064609\/peds_20170471.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T05:36:19Z","timestamp":1719293779000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/140\/2\/e20170471\/38708\/Allergy-Testing-in-Children-With-Low-Risk"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,1]]},"references-count":19,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,8,1]]},"published-print":{"date-parts":[[2017,8,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2017-0471","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,1]]},"article-number":"e20170471"}}