Berges-Gimeno M Pilar, Alvarez-Cuesta Emilio, Atanaskovic-Markovic Marina, Attanassi Marina, Caffareli Carlo, Caubet Jean-Christoph, du Toit George, Guzman-Melendez Antonieta, Kuyucu Semanur, Madrigal-Burgaleta Ricardo, Mayorga Lina, Powell Elizabeth, Ramien Michelle, Gomes Eva Rebelo, Mori Francesca, White Andrew A, Ansotegui Ignacio J, Vivolo Aun Marcelo, Barbaud Annick, Bavbek Sevim, Bernal-Rubio Lorena, Brockow Knut, Bustamante Lucrecia, Chang Yoon-Seok, Chiaverini Ensina Luis Felipe, Cuesta-Herranz Javier, Fernandes Bryan N, Garvey Lene Heise, Giavina-Bianchi Pedro, Kidon Mona I, Alvarez Marina Labella, Makowska Joanna S, Marinho Susana, Mendoza-Hernández David Alejandro, Pagani Mauro, Pino Valeria Palma, Parisi Claudio A S, Park Hae-Sim, Peter Jonathan, Phillips Elizabeth J, Risma Kimberly, Solano-Solares Emilio, Tanno Luciana Kase, Valluzzi Rocco Luigi, Vazquez-Revuelta Paula, Watts Timothy J, Yamaguchi Masao
Department of Allergy, Hospital Universitario Ramón y Cajal, Spain.
Academic in Allergy and Immunology, Allergy Division, Former Head, Ramon & Cajal University Hospital, Madrid, Spain.
World Allergy Organ J. 2025 Aug 29;18(9):101087. doi: 10.1016/j.waojou.2025.101087. eCollection 2025 Sep.
Drug hypersensitivity reactions (DHRs) in children and adolescents are less common than in adults but can have serious consequences if mismanaged. Mislabeling children as drug-allergic due to incomplete diagnostic evaluations leads to unnecessary medication restrictions, increased healthcare costs, and suboptimal treatment choices. This Statement from the World Allergy Organization (WAO) provides evidence-based recommendations for evaluating and managing pediatric DHRs, emphasizing accurate diagnosis through and testing, risk stratification, and personalized approaches. Antibiotics, particularly β-lactams, and non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently implicated drugs, with non-immediate reactions, such as maculopapular exanthema, being the most common presentation. The document also addresses emerging concerns, including monoclonal antibody-induced anaphylaxis and drug-induced enterocolitis syndrome. It underscores the need for specialized care in allergy centers with expertise in pediatric populations and advocates for multidisciplinary programs to manage complex cases, such as chemotherapy hypersensitivity and perioperative drug allergy. By addressing diagnostic challenges and clinical uncertainties, this document aims to improve the management of DHRs in children, reduce mislabeling, and enhance patient outcomes worldwide.
儿童和青少年的药物过敏反应（DHRs）比成人少见，但如果处理不当可能会产生严重后果。由于诊断评估不完整而将儿童误标记为药物过敏会导致不必要的用药限制、医疗成本增加以及治疗选择不佳。世界过敏组织（WAO）的这份声明为评估和管理儿童DHRs提供了循证建议，强调通过……和……检测进行准确诊断、风险分层以及个性化方法。抗生素，尤其是β-内酰胺类抗生素，以及非甾体抗炎药（NSAIDs）是最常涉及的药物，非即刻反应，如斑丘疹，是最常见的表现形式。该文件还涉及了新出现的问题，包括单克隆抗体诱导的过敏反应和药物性小肠结肠炎综合征。它强调了在具有儿科专业知识的过敏中心提供专科护理的必要性，并倡导开展多学科项目来管理复杂病例，如化疗过敏和围手术期药物过敏。通过应对诊断挑战和临床不确定性，本文件旨在改善儿童DHRs的管理，减少误标记，并提高全球患者的治疗效果。
