Serum sickness-like reactions in Iranian children: a registry-based study in a referral center

Allergol Immunopathol (Madr). 2020 Sep-Oct;48(5):424-429. doi: 10.1016/j.aller.2019.07.012. Epub 2020 Jul 8.


Introduction and objectives: Considering that no studies have been done on a comprehensive review of Serum sickness-like reactions patients (SSLRs) at a referral center in Iran so far, this study aimed to determine the clinical and laboratory characteristics of children with SSRL in Tehran Children's Medical Center.

Patients: The present study was a registry-based study in which the data of 94 SSLRs patients registered in a two-year period were investigated. Confirmation of fever, rash, urticaria, arthralgia / arthritis and history of antibiotic consumption up to three weeks before were the criteria for the diagnosis.

Results: Fifty-one (54 %) patients were male with mean age of 56 ± 30 months and there was no significant difference in the age of the two genders. The mean onset of symptoms before hospitalization were 3.8 ± 2.7 days (1-14 days); this mean was significantly higher in males than in females (4.6 ± 2.9 versus 2.9 ± 1.7 days, P-value = 0.003). Among antibiotics, Co-amoxiclav and Cefixime antibiotics had the most frequency by 31 % and 33 %, respectively as the most important incidence factor of SSLRs. The mean duration of consumption of culprit medications in the incidence of SSLRs was 5.6 ± 2.9 days with a range of 1-15 days.

Conclusions: This study showed that among the antibiotics, Co-amoxiclav and Cefixime are more prevalent and a review of prescribing these two antibiotics for the treatment of the children's infections is essential if this finding is confirmed by other Iranian scholars.

Keywords: Antibiotics; Iranian children; serum sickness-like reactions.

MeSH terms

  • Amoxicillin-Potassium Clavulanate Combination / adverse effects
  • Anti-Bacterial Agents / adverse effects*
  • Bacterial Infections / drug therapy*
  • Cefixime / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Iran / epidemiology
  • Male
  • Prevalence
  • Registries / statistics & numerical data
  • Serum Sickness / epidemiology*
  • Serum Sickness / etiology
  • Sex Factors


  • Anti-Bacterial Agents
  • Amoxicillin-Potassium Clavulanate Combination
  • Cefixime