Turkish Archives of Pediatrics
Original Article

Evaluation of Suspected Macrolide Allergies in Children


Division of Pediatric Allergy and Immunology, Department of Pediatrics, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey

Turk Arch Pediatr 2022; 57: 81-86
DOI: 10.5152/TurkArchPediatr.2022.21223
Read: 76 Downloads: 47 Published: 29 December 2021

Objective: Macrolides are often accepted as safe antibiotics due to their low allergenicity. However, studies on macrolides, particularly studies evaluating cross-reactivity in macrolides, are highly rare in children. This study aimed to evaluate the clinical manifestations, confirmation rate, and frequency of cross-reactivity in children admitted with suspicious clarithromycin or azithromycin allergy.

Materials and Methods: A total of 61 children suspected of macrolide antibiotic allergy (clarithromycin, n = 39 and azithromycin, n = 22) were evaluated. Allergy work-up including drug provocation tests were performed in all patients to confirm drug allergy.

Results: Macrolide allergy was confirmed in 9.8% (n = 6) of patients (azithromycin, 18.2% [n = 4] and clarithromycin, 5.1% [n = 2]). There was no significant difference between the confirmation rate of clarithromycin and azithromycin (P = .117). Cross-reaction with clarithromycin was confirmed in 2 (33.3%) patients with azithromycin allergy.

Conclusion: Drug skin tests are not capable of confirming or ruling out macrolide allergy, and oral provocation tests are essential for a definitive diagnosis. Cross-reactivity, albeit rare, can occur between clarithromycin and azithromycin, which are the most frequently used macrolides in children. 

Cite this article as: Süleyman A, Yücel E, Tamay ZÜ, Güler N. Evaluation of suspected macrolide allergies in children. Turk Arch Pediatr. 2022;57(1):81-86.

EISSN 2757-6256