ArticleEuropean journal of pediatrics2026
Delabelling suspected amoxicillin allergy in pediatric patients using oral challenge: a retrospective study from Northwestern Ontario.
Article in European journal of pediatrics, 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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5 authors.
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Abstract
To determine the proportion of children labelled as allergic to amoxicillin who are truly allergic and to assess whether a direct oral amoxicillin challenge, without prior skin testing, is a safe and effective way to remove incorrect allergy labels in low-risk pediatric patients in Northwestern Ontario. We conducted a retrospective review of pediatric patients (6 months-15 years) referred for suspected amoxicillin allergy at two Northwestern Ontario hospitals between 2015 and 2025. Eligible patients underwent oral amoxicillin challenge. Clinical data were summarized descriptively. Of 96 patients, 93 (96.9%) tolerated the oral amoxicillin challenge, while 3 (3.1%) developed mild, delayed rashes. All three had previously reported delayed reactions (5-10 days) after their initial amoxicillin exposure. Two patients developed delayed rashes that were consistent with their previously documented maculopapular reactions, based on EMR documentation and caregiver-reported descriptions.Conclusion: The prevalence of true amoxicillin allergy among low-risk pediatric patients carrying a reported "penicillin allergy" label in our cohort of 96 patients evaluated at our pediatric allergy clinics in Northwestern Ontario was 3.1%. Oral amoxicillin challenge without prior skin testing proved to be a safe and effective approach for delabelling low-risk children. Broader implementation of this strategy could enhance antibiotic stewardship, reduce healthcare-related costs, and improve patient care.
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