Paediatric Allergy Service

Reviewed on : 14 Jun 2022

Reviewed by : Anjli Jethwa Consultant Paediatrician

Expires : 14 Jun 2024

About the Paediatric Allergy Service

The members of the UHCW NHS Trust team include:

Dr Anjli Jethwa Consultant Paediatrician with Allergy Interest
Dr Colin MacDougall Consultant Paediatrician with Allergy Interest

Lead Health Professionals

Ms Louise Bashford Children’s Allergy Specialist Nurse
Ms Sarah Pitts Children’s Allergy Specialist Nurse
Ms Catherine Weller Children’s Allergy Specialist Nurse
Ms Hayley James Children’s Respiratory Specialist Nurse
Ms Katherine Brady Children’s Respiratory Specialist Nurse

Drug Allergy in Children

Guidance regarding referral advice for the Paediatric Allergy Service should be read in conjunction with NICE CG183 Diagnosis and Management of drug allergy www.nice.org.uk/guidance/cg183

Drug Allergy Assessment

Immediate reactions usually occur <1hour after drug exposure
Non–Immediate reactions occur within a few days or weeks

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

Inclusion Criteria

Anaphylaxis
Severe non-immediate cutaneous reactions eg Stevens Johnson Syndrome
Drug allergy during general anaesthesia
If in case of presumed beta lactam and or cephalosporin / cephalosporin allergy a specific condition can only be treated by a beta lactam
If there is likely to be recurrent requirement for that drug in the future eg beta lactam allergy in patient with immunodeficiency

Allergy to more than one class of antibiotic If the reaction was an immediate type please refer to the Paediatric allergy team and whilst waiting for the appointment please give the following advice:

Complete avoidance of the allergen is the most important aspect of management

If signs of anaphylaxis prescribe an Adrenaline Auto Injector and an Anti-Histamine. Guidance and doses can be found in the BNFc, Anaphylaxis Campaign and Resuscitation Council:

Referral information required

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

Exclusion Criteria

The following groups of patients should be referred to General Paediatric clinics and NOT the allergy service:

Infant feeding and possible Cow’s Milk Protein Intolerance (Very few children with reflux actually have an intolerance and true IgE mediated cow’s milk protein allergy is very rare – only 2.22% of children with a Cow’s milk intolerance have a true IgE mediated allergy )
Urticaria with no identifiable allergen

Further information

Demand for allergy services nationwide is rising due to raised awareness of allergic conditions high profile cases in the media and an increase in the incidence of several types of food and airborne allergies.

Currently there is a 6 month waiting list for new patients

GP expediting of appointments is not possible except in children with true anaphylaxis (cardiovascular or respiratory compromise or altered conscious state as a result of exposure to an allergen).

Please bear this in mind when discussing appointments with patients.