Reviewed on : 14 Sep 2017

Reviewed by : Dr Pamela Lewis, Paediatric Consultant, UHCW

Expires : 14 Sep 2019

Drug Allergy in Children

Referral guidance for General Practice

This guidance is intended to guide practitioners as to which children should be referred to the paediatric allergy service for further evaluation.   It should be read in conjunction with NICE CG183 Diagnosis and Management of drug allergy www.nice.org.uk/guidance/cg183

Drug allergy Assessment

• Immediate v Non-immediate Reactions
• Immediate Usually <1hour after drug exposure
• Non –Immediate – onset within a few days to weeks

See Nice.org.uk CG183 pages 10-11 for distinguishing features www.nice.org.uk/guidance/cg183

Children Requiring Referral

1. Anaphylaxis
2. Severe non-immediate cutaneous reactions eg SJS
3. Drug allergy during general anaesthesia
4. If in case of presumed beta lactam and or cephalosporin/cephalosporin allergy a specific condition can only be treated by a beta lactam
5. If there is likely to be recurrent requirement for that drug in the future eg beta lactam allergy in patient with immunodeficiency
6. Allergy to > 1 class of antibiotic

Requirements from General Practitioners

• Clear history of events and examination findings
• Drug implicated
• Strength/formulation/route
• Condition being treated
• Previous exposure history
• Time between administration of dose and onset of symptoms
• Number of doses before onset

No testing is required prior to referral

Referrals should be directed to the paediatric allergy team at UHCW NHS Trust