Pediatric antibiotic labels are common, and unnecessary antibiotic avoidance is associated with negative personal and public health outcomes; as a result, there is an increasing emphasis on the importance of pediatric antibiotic allergy evaluations. Different testing strategies have been advised, including skin testing and challenge testing with varied doses and duration. Established consensus testing protocols are lacking. The United States Drug Allergy Registry Pediatrics (USDAR-Peds) is a multi-site prospective study designed for epidemiology and outcome evaluations of pediatric drug hypersensitivity reactions (HSRs). Interpretation of multi-site data requires a uniform clinical approach, and the USDAR-Peds standardized protocols were developed in response to this need. This rostrum aims to provide a rationale and framework for standardization for pediatric antibiotic allergy protocols and assessment of positive reactions through a pediatric-specific adaptation of the USDAR immediate reaction grading scale to create consistency for multi-site research collaboration efforts such as USDAR-Peds.
Keywords: antibiotic; cephalosporin; drug challenge; fluoroquinolone; hypersensitivity; macrolide; pediatric; penicillin; sulfonamide.
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