Drug Allergy Clinic at Leeds Children’s Hospital - Information for parents and carers
Your child has been referred to the drug allergy clinic due to having a previous adverse reaction or suspected allergic reaction to a medication. They are usually referred by your GP but can also be referred by other health care professionals such as paediatricians or other specialist doctors or nurses your child may see. Your child will need to avoid the suspected drug until they have been seen by the allergy team.
Side effects and adverse reactions to medications are not uncommon in children, but it is rarely due to allergy. Often a child will be prescribed an antibiotic to treat an infection and develop a rash soon afterwards. It can be difficult to know if it is the antibiotic or the infection that has caused it. Your GP will err on the side of caution and label your child allergic to a particular medication, such as penicillin, rather than risk a further reaction. It is important to investigate if it is a true allergy so that medication can be given safely in the future.
Your child’s appointment will take place in the Children’s Outpatient Department in Martin Wing of Leeds General Infirmary. When you arrive the reception staff will check you in and a nurse will do your child’s height and weight. The appointment will be led by the consultant with a children’s allergy nurse supporting them.
To determine if your child has a drug allergy the consultant will ask about what happened when the suspected drug was given. This will include questions about the illness your child was suffering from at the time and how long after giving the drug the possible reaction appeared. They will ask what symptoms appeared. If a rash developed is helpful to describe the rash. Parents and carers often have photos on their smart phones, so feel free to show the consultant these.
Depending on the history and the details you give, the next step may be to have some tests.
- Skin prick tests – small drops of the suspected medication are placed on the skin and the skin is pricked through the drops.
- Intra dermal testing – a small amount of the suspected drug is injected into the top layer of the skin. This is done using a very tiny needle.
- Blood tests
The consultant will decide which testing is needed. The results of skin prick testing and intra-dermal testing are quick and the results are known in 10-20 minutes. Blood tests will take a few days at least. These tests can be uncomfortable, but most children are able to tolerate them.
Following this the consultant will discuss the next step. This often will involve a challenge to the suspected drug. There are 2 types of challenges we offer. A long or short protocol. Both challenges are done in the hospital under medical supervision by the children allergy nurses. With a doctor available if needed.
Short protocol – the suspected drug will be given to your child over 2 doses. If no immediate reaction is seen the child will go home with a bottle of the drug to continue for 3 days. You then contact the allergy nurses if any reaction occurs at home.
Long protocol – the suspected drug will be given to your child over 4-5 doses.
The type of challenge your child has will be decided by the history of the reaction they experienced.
After the challenge
Following the challenge, we will know if your child is allergic to that particular drug. If they are confirmed as allergic this drug will need to be avoided. We will write to your GP to confirm the allergy so that an alert can be made on their notes. Any medical professional involved with your child will need to be made aware of this drug allergy.
If there is no reaction to the drug following the challenge, will write to your GP asking them to take the allergic label from their notes and the drug can be used in the future.