{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:09:19Z","timestamp":1784257759341,"version":"3.55.0"},"reference-count":16,"publisher":"Oceanside Publications Inc.","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"\n Background:<\/jats:bold>\n Beta-lactam allergy (BLA) labels are common in children but often disproven when formally evaluated. This diagnostic discrepancy leads to higher health-care costs and increased adverse outcomes. Beta-lactam antibiotics are associated with a variety of adverse\n reactions in children. A serum sickness\u2010like reaction (SSLR) is one adverse reaction that is complex in its diagnosis and management due to its heterogeneous clinical presentation and poorly understood mechanism. This unclear presentation and diagnostic criteria can be confusing for\n patients, families, and health-care professionals, leading to allergy evaluation hesitancy. With updated drug practice parameters that support the utility of oral drug challenges for patients with SSLRs related to beta-lactams, barriers remain for these patients to seek allergy evaluation.\n Objectives:<\/jats:bold>\n The objective was to assess caregiver perspectives on BLA delabeling and identify barriers to drug challenge testing in children with a history of SSLRs.\n Methods:<\/jats:bold>\n We conducted an 18-question telephone survey with 14 caregivers of children with\n a history of beta-lactam\u2010associated SSLR. The survey assessed attitudes toward allergy delabeling, understanding of challenge testing, and perceived barriers to testing.\n Results:<\/jats:bold>\n Most caregivers demonstrated an understanding of the importance of allergy delabeling;\n however, the comfort level with challenge testing varied, depending on the setting, provider, and perceived risk of SSLR recurrence. Of the caregivers, 62.4% reported feeling comfortable with their child\u2019s pediatrician performing the testing. When asked about their concerns about testing,\n nearly 50% of caregivers expressed concern about the possibility of a repeated SSLR.\n Conclusion:<\/jats:bold>\n The overall positive attitude toward BLA testing, especially in a primary care setting, highlights an opportunity to make testing more accessible for patients. However, the\n unpredictable nature of SSLRs seems to contribute to caregiver reservations about pursuing testing for their child. To mitigate this, targeted education from health-care professionals, such as physicians, advanced practice providers, and nurses, may reduce caregiver hesitancy and facilitate\n BLA delabeling for patients with SSLRs.\n <\/jats:p>","DOI":"10.2500\/aap.2025.46.250059","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T04:32:17Z","timestamp":1761712337000},"page":"478-483","source":"Crossref","is-referenced-by-count":2,"title":["Caregiver perceptions of \u03b2-lactam allergy testing for serum sickness-like reactions"],"prefix":"10.2500","volume":"46","author":[{"given":"Grace E.","family":"Selner","sequence":"first","affiliation":[{"name":"From the University of Texas Southwestern Medical Center, Department of Medical School, Dallas, Texas and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory E.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Departments of Pediatrics and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy G.","family":"Chow","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Departments of Pediatrics and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1355","reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"586407","DOI":"10.3389\/fphar.2020.586407","article-title":"Viral infections and cutaneous drug-related eruptions","volume":"11","author":"Anci","year":"2021","journal-title":"Front Pharmacol"},{"key":"B2","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"},{"key":"B3","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/j.anai.2025.03.006","article-title":"Do not wait to challenge children: results of a standard operating procedure for low-risk antibiotic challenges","volume":"134","author":"Koo","year":"2025","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B4","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.jaip.2022.11.035","article-title":"The safety of the direct drug provocation test in beta-lactam hypersensitivity in children: a systematic review and meta-analysis","volume":"11","author":"Srisuwatchari","year":"2023","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B5","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.jaip.2018.09.003","article-title":"Antibiotic allergy labels in children are associated with adverse clinical outcomes","volume":"7","author":"Lucas","year":"2019","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B6","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1016\/j.jaip.2023.03.018","article-title":"Impact of penicillin allergy label on clinical outcomes of pneumonia in children","volume":"11","author":"Kaminsky","year":"2023","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B7","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.jaip.2025.01.041","article-title":"Serum sickness-like reactions in children - 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