Abstract

Severe antibiotic allergies are rare and widely overestimated. In children who present to the pediatric emergency department (ED) an antibiotic allergy is reported in 10% of cases, and frequency reaches 20-25%. in hospitalized patients. A true immune-mediated antibiotic hypersensitivity can be confirmed in only 5% of these patients. Many parents report their children as suspected to have “penicillin allergy” without clearly remembering or understanding the reaction and frequently this suspicion is uncritically accepted as a true allergy and reported in diaries and medical records. Methods for “delabeling” cases of uncertain diagnosis are an important goal of the healthcare system given the fact that a false beta lactam diagnosis leads to antibiotic resistance, prescription of not equally effective drugs with higher costs and long-lasting diseases. Furthermore, especially for a child it is not ethically acceptable to receive a wrong diagnosis that lasts their entire life.

This article provides practical guidance for correct management of an overestimated problem that does not promote judicious antibiotic use

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Authors

Fabrizio Franceschini - Private Practice in Allergy, Ancona, Italy

Giuseppe Crisafulli - Allergology Unit, Pediatric Department, University of Messina, Messina, Italy

Francesca Saretta - Primary Care Pediatrician, Azienda Sanitaria, Universitaria Friuli Centrale, Udine, Italy

Paolo Bottau - Pediatric and Neonatology Unit, Imola Hospital, Imola, Italy

Silvia Caimmi - Clinica Pediatrica Unit, San Matteo Hospital, University of Pavia, Pavia, Italy

Annamaria Bianchi - Pediatric Unit, San Camillo Forlanini Hospital, Roma, Italy

Lucia Liotti - Pediatric Unit, Salesi Hospital, Ancona, Italy

Francesca Mori - Allergy Unit, Meyer Children’s Hospital IRCCS, Florence, Italy

Sara Riscassi - Pediatric Department, Bolzano Hospital, Bolzano, Italy

Rocco Luigi Valluzzi - Allergology Unit, Pediatric Department, Bambino Gesu’ Pediatric Hospital, Roma, Italy

Carlo Caffarelli - Clinica Pediatrica Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy

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How to Cite
Franceschini, F., Crisafulli, G., Saretta, F., Bottau, P., Caimmi, S., Bianchi, A., Liotti, L., Mori, F., Riscassi, S., Valluzzi, R. L., & Caffarelli, C. (2025). A Management of reported beta lactam hypersensitivity in the emergency department setting. Italian Journal of Pediatric Allergy and Immunology, 39(1). https://doi.org/10.53151/2531-3916/2025-1072
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