Abstract

FELIX, Mara et al. Evaluation of penicillin G sensitization in adolescents with rheumatic fever. Rev Port Imunoalergologia [online]. 2012, vol.20, n.4, pp.281-290. ISSN 0871-9721.

Background: Penicillin is the antibiotic of first choice for primary and secondary prophylaxis of rheumatic fever (RF). The incorrect diagnosis of penicillin allergy in these patients excludes a therapeutic option with high efficiency and low cost. Objective: Estimate the prevalence of sensitization to penicillin among adolescents in treatment for RF. Methods: Cross -sectional study conducted at the Center for Adolescent Health - State University of Rio de Janeiro, with patients between 12 -19 years. During a routine visit, they underwent a questionnaire with data about immediate hypersensitivity to penicillin, skin tests (ST) with benzylpenicillin 10.000UI/mL (prick and intradermal) and prick tests with aeroallergens (AL). The total number of injections of benzathine penicillin (TBP) used for prophylaxis from diagnosis of RF to the date of the questionnaire was calculated for each patient. Differences in relation to gender, age and atopy among reactors (R) and non-reactors (NR) to ST for penicillin were analyzed by χ test and those on the TBP by Student’s t -test (significant p<0.05). Results: Between January to December 2009, we evaluated 75 patients (37 female; mean age: 15.9 ± 2.1 years). Of these, 8% were positive ST for penicillin G. History of previous adverse reaction to penicillin was seen in 2 R (33%) and 2 NR (2.9%) (RP=11.5; 95%CI: 1.9 -67). There was no significant difference between R and NR in relation to gender and age. All R had history of asthma and/or rhinitis and positive ST for AL while among NR these percentages were 39.1% and 20.3% respectively. Conclusions: Benzylpenicillin proved to be safe and able to confirm sensitization in patients with a history of immediate hypersensitivity to this drug. This is a simple test with low cost and very important for the evaluation of these patients, especially those with RF

Keywords : Adolescents; allergy; children; penicillin; rheumatic fever.

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