Proven Immunologically-Mediated Drug Hypersensitivity in Children with A History of Multiple Drug Intolerances.

BACKGROUND: Children may be referred to pediatric allergy clinics for reactions to multiple drugs. Multiple drug hypersensitivity (MDH) is defined as immunologically-mediated hypersensitivity to two or more chemically different drugs.

OBJECTIVE: The aim of this study is to report the allergy work-up results of children who had a history of potential hypersensitivity reactions to two or more unrelated drugs.

METHODS: This study was conducted in the Pediatric Allergy and Immunology department of our hospital. Children who described hypersensitivity reactions to two or more drugs were included and were evaluated by allergy work-up (skin and/or provocation tests) between January 2011 and July 2016.

RESULTS: During the study period, 886 children were evaluated for a history of drug intolerance. Of these children, 73 (8.2%) had a history of drug reactions to two or more chemically different drugs. The median age of the children who had a history of reactions to two or more drugs was 7.8 (min-max: 2.5-16.4) years, and 59% (n=43) were male. Among the suspected drugs, antibiotics (65.9%) ranked first and non-steroid antiinflammatory drugs (34.1%) were the second. All 73 children were evaluated with skin and/or provocation tests with the suspected drugs, and MDH was confirmed in only two (2.7%) children.

CONCLUSION: Multiple drug hypersensitivity is uncommon in children. The incidence and prevalence of MDH may vary with the specific population studied. Evaluating children with a history of MDH, by performing drug hypersensitivity testing, will help avoid the morbidity associated with unnecessary drug avoidance.