Drug hypersensitivity reactions (DHR) affect significant portion of pediatric population. The most common immunopathogenetic mechanisms are specific IgE mediated reactions or specific T cells mediated reactions.
Part of adverse drug reactions has no immunological basis. The most frequent drugs causing DHR are antibiotics, especially beta-lactams, further drugs causing perioperative allergic reactions, non-steroidal anti-inflammatory drugs and less frequently chemotherapeutics, contrast media or vaccines.
The basis of DHR diagnosis is carefully obtained history followed by skin testing, eventually drug provocation test. Optimal result of diagnostic procedure is the finding of a culprit drug and suggestion of an appropriate alternative medication.