ArticlePediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology2026
Attitudes of caregivers of children labeled with drug allergy after delabeling by provocation tests.
Article in Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Attitudes of caregivers of children labeled with drug allergy after delabeling by provocation tests.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Article
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6 authors.
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Abstract
backgroundMislabeling children as drug-allergic leads to suboptimal, costly, and potentially harmful treatments. Although drug provocation tests (DPTs) are the gold standard for excluding drug hypersensitivity, the impact of these interventions on caregivers' willingness to reuse delabeled drugs remains elusive. We evaluated DPT outcomes and post-DPT drug use and caregiver attitudes in pediatric patients.
methodsWe analyzed children who underwent DPTs for suspected drug allergy at a tertiary pediatric allergy center between January 2019 and June 2023. Demographic and clinical data were reviewed, and caregivers were contacted ≥6 months after DPT to assess subsequent drug use and concerns.
resultsA total of 254 DPTs were performed in 198 children (55.1% male; median age: 58 months). Drug allergy was confirmed in 25.3% of patients (50/198), corresponding to 22.0% of tests (56/254). Among 162 negative DPTs with follow-up, the suspected drug was reused in 56.8% of cases; 92.4% were tolerated while 7.6% resulted in mild reactions. Multivariable logistic regression identified predictors of drug reuse: paracetamol (aOR: 7.40; 95% CI: 1.73-31.63; p = .007), concomitant allergic disease (aOR: 2.51; 95% CI: 1.12-5.64; p = .026), self-referral (aOR: 3.81; 95% CI: 1.12-12.95; p = .032), and younger age (aOR per month: 0.99; 95% CI: 0.98-1.00; p = .017). Anaphylaxis at index reaction was associated with reduced reuse likelihood (aOR: 0.21; 95% CI: 0.06-0.76; p = .018).
conclusionDespite negative DPT results, almost half of caregivers did not reuse the suspected drug, mostly due to fear or miscommunication. These findings highlight the importance of post-DPT education and structured follow-up to optimize delabeling outcomes.
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