Drug hypersensitivity reactions in children in clinical practice: A WAO Statement
María Pilar Berges‐Gimeno, Emilio Álvarez-Cuesta, Marina Atanasković‐Marković, Marina Attanassi, Carlo Caffarelli, Jean‐Christoph Caubet, George Du Toit, Antonieta Guzman-Melendez, Semanur Kuyucu, Ricardo Madrigal‐Burgaleta, Cristobalina Mayorga, Elizabeth Powell, Michele Ramien, Eva Gómes, Francesca Mori, Andrew A. White, Ignacio J. Ansotegui, Marcelo Vívolo Aun, A. Barbaud, Sevim Bavbek, Lorena Bernal-Rubio, Knut Brockow, Lucrecia Bustamante, Yoon‐Seok Chang, Luís Felipe Ensina, Javier Cuesta‐Herranz, Bryan N. Fernandes, Lene H. Garvey, Pedro Giavina‐Bianchi, Mona Kidon, Marina Labella, Joanna Makowska, Susana Marinho, David Alejandro Mendoza-Hernández, Mauro Pagani, Valeria Palma Pino, Cláudio Parisi, Hae‐Sim Park, Jonny Peter, Elizabeth J. Phillips, Kimberly Risma, E Solano-Solares, Luciana Kase Tanno, Rocco Luigi Valluzzi, Paula Vázquez‐Revuelta, Timothy J. Watts, Masao Yamaguchi
Abstract
testing, risk stratification, and personalized approaches. Antibiotics, particularly β-lactams, and non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently implicated drugs, with non-immediate reactions, such as maculopapular exanthema, being the most common presentation. The document also addresses emerging concerns, including monoclonal antibody-induced anaphylaxis and drug-induced enterocolitis syndrome. It underscores the need for specialized care in allergy centers with expertise in pediatric populations and advocates for multidisciplinary programs to manage complex cases, such as chemotherapy hypersensitivity and perioperative drug allergy. By addressing diagnostic challenges and clinical uncertainties, this document aims to improve the management of DHRs in children, reduce mislabeling, and enhance patient outcomes worldwide.