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Confirmed penicillin allergy among patients receiving benzathine penicillin prophylaxis for acute rheumatic fever.
[acute rheumatic fever]
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
.
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
.
T
he
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
.
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
.
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
.
Diseases
Validation
Diseases presenting
"penicillin allergy after detailed evaluation"
symptom
acute rheumatic fever
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