ABSTRACT
The frequency and severity of antibiotic rashes was investigated in a retrospective review of 5923 medical records of pediatric patients cared for in a community practice setting over a five month period. Approximately one-third (32%) of the patients did not receive antibiotics during this time period. However, antibiotic related reactions were documented in 8.6% (509) of the patients with 37 of these reactions classified as mild (e.g., gastrointestinal upset). The remaining 472 reactions were rash related. Of these reactions, there were no significant differences between the total number of boys and girls (53.8% vs 47.2%) who developed rashes, but there was a higher incidence observed in boys younger than three years of age, and in girls older than nine years. The highest incidence of reported rashes occurred in children who received cefaclor (12.3%), penicillins (7.4%), sulfonamides (8.5%), and other cephalosporins (2.6%). Urticarial type rashes (e.g., welts, hives, etc) were the most common, accounting for 45.9% (208) of the describable rashes. Thirty-one cases of serum sickness-like reactions were also observed in this patient population and were most frequently associated with cefaclor (1.9%), but also occurred in patients receiving penicillins (0.35 %) and sulfonamides (0.36%). During the study period, no cases of severe rash related reactions (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis) occurred. In addition, there were no deaths or hospitalizations related to antibiotic induced rashes.
