{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T20:59:23Z","timestamp":1764277163541,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T00:00:00Z","timestamp":1670803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Drug hypersensitivity reactions (DHRs) are a type of adverse drug reactions with heterogeneous pathophysiological mechanisms and a broad spectrum of clinical manifestations. Since over-diagnosing is common in children, a complete allergy work-up is needed. A cross-sectional study was conducted at a tertiary care institution, covering the five-year period. Five hundred and four patients of both sexes, mean age 7.5 and with a medical history suggestive of DHR were evaluated. ENDA\/EAACI guidelines were used for a diagnostic algorithm. Single drug hypersensitivity was registered in 375 patients and multiple drug hypersensitivity in 129. The main culprits in medical history were antibiotics (83%), non-steroidal anti-inflammatory drugs (NSAIDs) (8.4%) and analgoantipyretics (3.8%). Skin involvement was registered in 96.2%. DHRs were confirmed in 4.4% patients\u2014six patients had positive skin tests and 13 had a positive drug provocation test. In the proven DHRs group, the main agents were antibiotics (72.7%), followed by NSAIDs (8.3%), and of all the skin manifestations, urticaria was most common (78.2%), followed by exanthema (10.5%) and angioedema (5.3%). Considering the above, anticipating DHRs and a proper referral of children to an allergologist is a key step in the assessment of drug hypersensitivity. A complete allergy work-up prevents unnecessary drug exclusion and allows most children to safely continue the use of first-line medications when needed.<\/jats:p>","DOI":"10.3390\/children9121954","type":"journal-article","created":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T01:56:06Z","timestamp":1670896566000},"page":"1954","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Diagnosing Single and Multiple Drug Hypersensitivity in Children: A Tertiary Care Center Retrospective Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Katarina","family":"Milosevic","sequence":"first","affiliation":[{"name":"Department of Pulmonology and Allergology, University Children\u2019s Hospital, Tirsova 10, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, Dr. Subotica 8, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1021-2053","authenticated-orcid":false,"given":"Marija","family":"Malinic","sequence":"additional","affiliation":[{"name":"Clinic of Dermatovenereology, University Clinical Center of Serbia, Deligradska 34, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davor","family":"Plavec","sequence":"additional","affiliation":[{"name":"Medical Faculty Osijek, J. J. Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia"},{"name":"Srebrnjak Children\u2019s Hospital, Srebrnjak 100, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9927-0881","authenticated-orcid":false,"given":"Zoran","family":"Lekovic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr. Subotica 8, 11000 Belgrade, Serbia"},{"name":"Department of Gastroenterology, University Children\u2019s Hospital, Tirsova 10, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0987-4746","authenticated-orcid":false,"given":"Aleksa","family":"Lekovic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr. Subotica 8, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1655-8714","authenticated-orcid":false,"given":"Mina","family":"Cobeljic","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Neonatal Intensive Care, University Children\u2019s Hospital, Tirsova 10, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9987-057X","authenticated-orcid":false,"given":"Snezana","family":"Rsovac","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr. Subotica 8, 11000 Belgrade, Serbia"},{"name":"Department of Pediatric and Neonatal Intensive Care, University Children\u2019s Hospital, Tirsova 10, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1016\/S0140-6736(00)02799-9","article-title":"Adverse drug reactions: Definitions, diagnosis, and management","volume":"356","author":"Edwards","year":"2000","journal-title":"Lancet"},{"key":"ref_2","first-page":"203","article-title":"Drug allergy in children: What should we know?","volume":"63","author":"Park","year":"2020","journal-title":"Korean J. 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