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A Survey in a Private Practice Setting

Ekopimo O. Ibia, MD; Richard H. Schwartz, MD; Bernhard L. Wiedermann, MD

Arch Dermatol. 2000;136:849-854.

Objective  To document the frequency and severity of various types of rashes seen with commonly used oral antibiotics in the pediatric outpatient setting.

Design  A retrospective review of 5923 patient records at a pediatric office.

Setting  A private group pediatric practice in northern Virginia with about 12,000 registered active patients.

Patients and Methods  Approximately 50% of the clinic medical records were reviewed. All children (defined as those aged 0-18 years in this study) identified on their medical records as having developed a rash following treatment with 1 or more of the commonly used oral antibiotics were included in the study. For further validation, a questionnaire about parental recollection of description of rash, other associated symptoms, physician verification, and outcome was mailed to families with children designated as being allergic to an antibiotic.

Results  On a prescription basis, significantly more rashes were documented for cefaclor (4.79%) compared with penicillins (2.72%), sulfonamides (3.46%), and other cephalosporins (1.04%). Based on the number of patients for whom each group of antibiotic was prescribed, the documented frequencies of rashes were 12.3%, 7.4%, 8.5%, and 2.6% for cefaclor, penicillins, sulfonamides, and other cephalosporins, respectively. None of the children had rashes severe enough to require hospitalization.

Conclusions  In a review of almost 6000 records in a private pediatric primary care setting, rashes occurred in 7.3% of children who were given the commonly used oral antibiotics. Significantly more rashes were documented with cefaclor use than with use of any of the other oral antibiotics.

From the Department of Infectious Diseases, Children's National Medical Center, Washington, DC (Drs Ibia and Wiedermann); and Inova Hospital for Children, Falls Church, and Vienna Pediatric Associates Ltd, Vienna, Va (Dr Schwartz).

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