Results of drug hypersensitivity evaluations in a large group of children and adults

Clin Exp Allergy. 2012 Jan;42(1):123-30. doi: 10.1111/j.1365-2222.2011.03887.x. Epub 2011 Oct 13.


Background: Proven IgE or T-cell mediated drug hypersensitivity reactions (DHRs) seem less common in children compared with adults. However, this has never been proved by data.

Objective: To determine and compare proven DHR prevalence in children and adults.

Methods: Using the DAHD (Drug Allergy and Hypersensitivity Database) cohort, children with proven DHRs were compared with adults. The international EAACI-ENDA recommendations were followed. Patients were divided into four groups: index reaction and test during childhood (C/C), index reaction at childhood and test at adulthood (C/A), index reactions at childhood and adulthood and test at adulthood (CA/A), index reaction and test at adulthood (A/A).

Results: A total of 3275 patients (67.9% female), comprising a total of 4370 patient-episodes, were evaluated (74.5% belonged to the A/A group). Prevalence of positive tests was 15.2% (95%CI, 14.1-16.2) for all tested classes, 10.6% (8.3-13.0) for C/C, 10.6% (7.5-13.6) for C/A, 22.1% (12.8-31.3) for CA/A and 16.5% (15.2-17.8) for A/A. The prevalence was lower in group C/C compared with groups A/A (P < 0.0001) and CA/A (P = 0.003). It was also lower in group C/A compared with the two latter groups (respectively P = 0.003 and P = 0.005). Significant differences were found for maculopapular exanthemas only, and not for urticaria/angiœdema and anaphylaxis. The difference was mainly observed with β-lactams and not for NSAIDs.

Conclusion and clinical relevance: Suspicions of DHRs are less likely to be confirmed in children.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anaphylaxis / diagnosis
  • Anaphylaxis / epidemiology
  • Anaphylaxis / etiology
  • Angioedema / chemically induced
  • Angioedema / diagnosis
  • Angioedema / epidemiology
  • Anti-Bacterial Agents / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Child
  • Child, Preschool
  • Cohort Studies
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / epidemiology*
  • Drug Hypersensitivity / etiology*
  • Exanthema / chemically induced
  • Exanthema / diagnosis
  • Exanthema / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Urticaria / chemically induced
  • Urticaria / diagnosis
  • Urticaria / epidemiology
  • Young Adult


  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents, Non-Steroidal