Risk Factors for Drug Allergies in Pediatric Palliative Care Patients

Abstract

Background / aim: Children receiving pediatric palliative care constitute a medically fragile population. Despite this vulnerable clinical profile, data on drug allergy in pediatric palliative care remain scarce. This study aimed to determine the frequency, clinical characteristics, and associated factors of clinically defined drug allergy in children hospitalized in a tertiary pediatric palliative care center.Methods: This retrospective observational study included all children hospitalized in a tertiary pediatric palliative care center. Drug allergy was clinically defined according to predefined diagnostic criteria, and in vivo and/or in vitro allergy work-up was performed in selected patients. Demographic and clinical characteristics, hospitalization-related variables, and medication burden were compared between patients with and without drug allergy.Results: A total of 281 hospitalized children were included. Clinically defined drug allergy was identified in 26 patients (9.2%). Antimicrobials were the most frequently implicated drug group (57.7%), followed by antiepileptic drugs (11.5%) and non-steroidal anti-inflammatory drugs (7.7%). Most reactions were immediate (21/26), whereas 5 were non-immediate. One patient developed ranitidine-associated anaphylaxis, and one developed oxybutynin-associated DRESS. In multivariate analysis, older age (OR 1.168; 95% CI 1.036-1.316; p=0.011), longer hospital stay (OR 1.032; 95% CI 1.014-1.050; p