title: Confirmed penicillin allergy among patients receiving benzathine penicillin prophylaxis for acute rheumatic fever.
abstract: BACKGROUND
  Beta-lactam antibiotics are the most frequent drugs prescribed in children worldwide. Acute rheumatic fever (ARF) is the major cause of acquired heart disease among children and adolescents. Recurrences due to inadequate penicillin prophylaxis are responsible for chronic valvular lesions requiring surgery. The fear of a severe allergic reaction is the leading cause of discontinuing prophylaxis.
  
  
  OBJECTIVE
  In this study, we aimed to reveal the frequency of adverse events and real allergic reactions to benzathine penicillin among children who are followed in our paediatric cardiology clinic with a diagnosis of ARF.
  
  
  METHODS
  The children who were followed with a diagnosis of ARF between January 2005 and December 2011 were searched for a history of penicillin allergy. Patients with a positive history were evaluated in our paediatric allergy clinic. Skin tests and provocation tests were performed with parental consent.
  
  
  RESULTS
  In total 535 children with a diagnosis of ARF were analysed for the study. Median follow up period was 24 months (12-36) [median (%25-75)]. Eleven of our 535 (11/17.641 injection) ARF patients were suspected to have allergic reactions after 17.641 penicillin injections but only one (0.18%) was diagnosed to have penicillin allergy after detailed evaluation.
  
  
  CONCLUSIONS
  Our data suggest that the frequency of penicillin allergy is much lower than suspected among children on penicillin prophylaxis for ARF. Consequently, penicillin prophylaxis should not be given up without proper evaluation of drug allergy.
authors.affiliation: Ankara Children's Hematology Oncology Education and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Kaya
authors.affiliation: Ankara Children's Hematology Oncology Education and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Erkoçoğlu
authors.affiliation: Ankara Children's Hematology Oncology Education and Research Hospital, Department of Pediatrics, Ankara, Turkey.
authors.forename: O G
authors.initials: OG
authors.lastname: Senkon
authors.affiliation: Ankara Children's Hematology Oncology Education and Research Hospital, Department of Pediatric Cardiology, Ankara, Turkey.
authors.forename: F K
authors.initials: FK
authors.lastname: Ekici
authors.affiliation: Ankara Children's Hematology Oncology Education and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Toyran
authors.affiliation: Ankara Children's Hematology Oncology Education and Research Hospital, Department of Pediatric Cardiology, Ankara, Turkey.
authors.forename: I İ
authors.initials: Iİ
authors.lastname: Çetin
authors.affiliation: Ankara Children's Hematology Oncology Education and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey. Electronic address: cankocabas@yahoo.com.
authors.forename: C N
authors.initials: CN
authors.lastname: Kocabaş
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis / Q000009:adverse effects*; D002648:Child; D004342:Drug Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D010401:Penicillin G Benzathine / Q000009:adverse effects*; D012213:Rheumatic Fever / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D010401:Penicillin G Benzathine
keywords: Acute rheumatic fever; Benzathine penicillin prophylaxis; Penicillin allergy