{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T01:12:32Z","timestamp":1775265152045,"version":"3.50.1"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>Antibiotics are among the most common prescriptions in children, and non\u2013\u03b2-lactam antibiotics (NBLAs) account for almost half of those prescribed in Australian pediatric hospitals. Despite this, data on NBLA hypersensitivity in children are limited. This study describes reported hypersensitivity reactions to NBLAs in children and the results of allergy evaluation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Children with a suspected NBLA allergy who had skin testing and\/or an intravenous or oral challenge test (OCT) between May 2011 and June 2018 were included. Patients were excluded if they were &amp;gt;18 years old or did not complete the allergy evaluation for any reason other than allergic reaction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Over the 7-year study period, 141 children had 150 allergy evaluations of 15 different NBLAs. The median time from the initial reported reaction to allergy evaluation was 1.9 (range 0.1\u201314.9) years. Overall, 27 of the 150 (18.0%) challenge tests to NBLAs had positive results, with the rate of positive OCT results being highest for trimethoprim-sulfamethoxazole (15 of 46; 32.6%) and macrolides (8 of 77; 10.4%). Although 4 children reported initial anaphylactic reactions, no patients had severe symptoms on rechallenge or required adrenaline. Of the challenges that had positive results, the majority of children (23 of 27; 85.2%) had symptoms on repeat challenge similar to those that were initially reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Overall, 8 of 10 children with NBLA allergy could be delabeled. On average, patients waited 1.9 years to be rechallenged. Timely access to allergy evaluation to delabel these patients is needed to preserve first-line antibiotics.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2019-2256","type":"journal-article","created":{"date-parts":[[2019,12,3]],"date-time":"2019-12-03T13:25:10Z","timestamp":1575379510000},"source":"Crossref","is-referenced-by-count":14,"title":["Non\u2013\u03b2-Lactam Antibiotic Hypersensitivity Reactions"],"prefix":"10.1542","volume":"145","author":[{"given":"Lisa","family":"Grinlington","sequence":"first","affiliation":[{"name":"Departments of General Medicine and"},{"name":"Monash Health, Clayton, Victoria, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Choo","sequence":"additional","affiliation":[{"name":"Allergy and Immunology, The Royal Children\u2019s Hospital Melbourne, Parkville, Victoria, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noel","family":"Cranswick","sequence":"additional","affiliation":[{"name":"Departments of General Medicine and"},{"name":"Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; and"},{"name":"Murdoch Children\u2019s Research Institute, Parkville, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Gwee","sequence":"additional","affiliation":[{"name":"Departments of General Medicine and"},{"name":"Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; and"},{"name":"Murdoch Children\u2019s Research Institute, Parkville, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2020,1,1]]},"reference":[{"issue":"11","key":"2021121013133994000_B1","doi-asserted-by":"crossref","first-page":"657","DOI":"10.5694\/mja13.00154","article-title":"Australia-wide point prevalence survey of the use and appropriateness of antimicrobial prescribing for children in hospital","volume":"201","author":"Osowicki","year":"2014","journal-title":"Med J Aust"},{"issue":"5","key":"2021121013133994000_B2","doi-asserted-by":"crossref","first-page":"415","DOI":"10.2165\/11587540-000000000-00000","article-title":"Suspected adverse drug reactions reported for children worldwide: an exploratory study using VigiBase","volume":"34","author":"Star","year":"2011","journal-title":"Drug Saf"},{"issue":"4","key":"2021121013133994000_B3","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/pch\/7.4.233","article-title":"Allergy to antibiotics in children: perception versus reality","volume":"7","author":"Langley","year":"2002","journal-title":"Paediatr Child Health"},{"issue":"5","key":"2021121013133994000_B4","doi-asserted-by":"crossref","first-page":"e20172497","DOI":"10.1542\/peds.2017-2497","article-title":"Antibiotic allergy in pediatrics","volume":"141","author":"Norton","year":"2018","journal-title":"Pediatrics"},{"issue":"5","key":"2021121013133994000_B5","doi-asserted-by":"crossref","first-page":"e20173466","DOI":"10.1542\/peds.2017-3466","article-title":"Antibiotic use after removal of penicillin allergy label","volume":"141","author":"Vyles","year":"2018","journal-title":"Pediatrics"},{"issue":"1","key":"2021121013133994000_B6","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1159\/000443830","article-title":"Proven non-\u03b2-lactam antibiotic allergy in children","volume":"169","author":"Guvenir","year":"2016","journal-title":"Int Arch Allergy Immunol"},{"key":"2021121013133994000_B7","volume-title":"AURA 2017: Second Australian Report on Antimicrobial Use and Resistance in Human Health","author":"Australian Commission on Safety and Quality in Health Care (ACSQHC)","year":"2017"},{"issue":"17","key":"2021121013133994000_B8","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1056\/NEJMoa022963","article-title":"Absence of cross-reactivity between sulfonamide antibiotics and sulfonamide nonantibiotics","volume":"349","author":"Strom","year":"2003","journal-title":"N Engl J Med"},{"issue":"1","key":"2021121013133994000_B9","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s11882-007-0029-8","article-title":"Sulfonamide allergy and cross-reactivity","volume":"7","author":"Brackett","year":"2007","journal-title":"Curr Allergy Asthma Rep"},{"issue":"6","key":"2021121013133994000_B10","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"},{"key":"2021121013133994000_B11","unstructured":"Australian Society of Clinical Immunology and Allergy. 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