Accarino John J O, Chow Timothy G, Ramsey Allison, Rukasin Christine R F, Gonzalez-Estrada Alexei, Liu Anne Y, Khan David A, Blumenthal Kimberly G
Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Department of Medicine, Harvard Medical School, Boston, Mass.
Division of Allergy and Immunology, Departments of Pediatrics and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
J Allergy Clin Immunol Pract. 2025 May;13(5):1018-1026.e1. doi: 10.1016/j.jaip.2024.12.036. Epub 2025 Jan 2.
Pediatric antibiotic labels are common, and unnecessary antibiotic avoidance is associated with negative personal and public health outcomes; as a result, there is an increasing emphasis on the importance of pediatric antibiotic allergy evaluations. Different testing strategies have been advised, including skin testing and challenge testing with varied doses and duration. Established consensus testing protocols are lacking. The US Drug Allergy Registry Pediatrics (USDAR-Peds) is a multisite prospective study designed for epidemiology and outcome evaluations of pediatric drug hypersensitivity reactions. Interpretation of multisite data requires a uniform clinical approach, and the USDAR-Peds standardized protocols were developed in response to this need. This rostrum aims to provide a rationale and framework for standardization for pediatric antibiotic allergy protocols and assessment of positive reactions through a pediatric-specific adaptation of the USDAR immediate reaction grading scale to create consistency for multisite research collaboration efforts such as USDAR-Peds.
儿科抗生素标签很常见，而不必要地避免使用抗生素会带来负面的个人和公共健康后果；因此，人们越来越重视儿科抗生素过敏评估的重要性。已建议采用不同的检测策略，包括皮肤检测以及不同剂量和时长的激发试验。目前缺乏既定的共识检测方案。美国药物过敏登记处儿科项目（USDAR-Peds）是一项多中心前瞻性研究，旨在对儿科药物过敏反应进行流行病学和结果评估。对多中心数据的解读需要统一的临床方法，USDAR-Peds标准化方案正是为满足这一需求而制定的。本报告旨在通过对USDAR即时反应分级量表进行儿科特异性调整，为儿科抗生素过敏方案的标准化以及阳性反应评估提供理论依据和框架，从而为诸如USDAR-Peds这样的多中心研究合作努力创造一致性。
