ArticleInternational archives of allergy and immunology2026
Drug-Induced Anaphylaxis in Children: A Comparative Analysis of Inpatient versus Outpatient Settings.
Article in International archives of allergy and immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionStudies specifically focusing on drug-induced anaphylaxis (DIA) in children are few. There is no study comparing inpatient (IP) and outpatient (OP) settings in DIA, either in children or in adults. We aimed to compare the characteristics of pediatric DIAs observed in IP and OP settings.
methodsPatients aged ≤18 years who were diagnosed with DIA at our institution over the past 15 years were included in the study. The diagnosis of DIA was made clinically, and diagnostic testing was performed in eligible patients. Patients were categorized as IP and OP groups based on the settings in which DIA occurred.
resultsA total of 162 pediatric DIAs (55% IP vs. 45% OP) were reviewed. The most frequent triggering drugs were chemotherapeutics, enzyme replacement therapies for metabolic disorders, and antibiotics in IP group, and NSAIDs, antibiotics, and local anesthetics in OP group. Parenteral drug use was more frequent in IP group (p < 0.001). Age at DIA, time to DIA, and severity of DIA were similar between the two groups. However, after excluding parenteral drugs from OP group, significant differences in all three parameters were seen in IP group (p < 0.05 for each). Patients in IP group had more nonallergic chronic comorbidities and gastrointestinal symptoms, while OP group showed higher rates of asthma, allergic rhinitis, and acute infections as cofactors (p ≤ 0.001 for each). Antihistamine and systemic corticosteroid use were higher in OP group (p < 0.05 for each), but the use of intramuscular adrenaline was similar in both groups.
conclusionTriggering drugs, clinical presentations, management, chronic allergic and nonallergic comorbidities, and cofactors in pediatric DIA differ between the two groups. Contrary to expectations, the setting did not affect the onset or severity of DIA, likely due to the higher frequency of parenteral drug administration in OP settings.
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