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To comprehensively delineate the entire range of symptoms linked with amoxicillin-associated reactions (AARs) in pediatric patients in the emergency department (ED) and urgent care facility (UC).
"Worrisome" symptoms, including fever, angioedema, and gastrointestinal symptoms, are frequent in children with reactions/allergies to Amoxicillin (antibiotic medication) in acute care settings.
To comprehensively delineate the entire range of symptoms linked with amoxicillin-associated reactions (AARs) in pediatric patients in the emergency department (ED) and urgent care facility (UC).
This retrospective analysis of medical records for pediatric patients seen in the ED/UC between July 1, 2015, and June 30, 2017, meticulously documented clinical manifestations, timing of symptoms, and seasonal patterns. These cases were categorized into 3 regular presentations of AAR: urticaria, maculopapular exanthem (MPE) and serum sickness-like reactions (SSLRs) characterized by the presence of joint symptoms.
A total of 668 children, with a median age of 1.8 years, sought care in the ED/UC for urticaria (44%), MPE (36%), and SSLRs (11%), usually happening between days 7 to 10 following the exposure to Amoxicillin.
Children experiencing SSLRs were more commonly administered corticosteroids (28%, P < .0001) and displayed higher rates of "worrisome" features, such as angioedema, fever or gastrointestinal symptoms (73%). Surprisingly, a significant proportion of children (10%) returned to the ED/UC for re-examination.
The presence of "worrisome" symptoms is prevalent among children presenting to the ED/UC with allergies or reactions to Amoxicillin. Further investigations are necessary to evaluate the implications of these findings on subsequent referrals and allergy testing.
The Journal of Allergy and Clinical Immunology
Distinct Characteristics and Chronology of Amoxicillin-Associated Reactions in Pediatric Acute Care Settings
Katharine M Guarnieri et al.
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