Associate Professor Michaela Lucas is a Clinical Immunologist/ Immunopathologist at the adult tertiary Sir Charles Gairdner Hospital, Princess Margaret Hospital for Children and Pathwest Laboratory Medicine in Perth, Western Australia. Her main research interests are in T-cell immunology, with special emphasis on interplay of innate and adaptive immunity during chronic viral infection, transplantation immunology and drug hypersensitivity. After a doctorate in Biochemistry, a European Marie-Curie Fellowship and a post-doctoral position at Oxford University, Michaela moved to Australia in 2004, where she completed her Basic and Advanced Physician training in Clinical Immunology and Immunopathology in 2012. Since early 2014 she has been the Group Leader of a Immunology Laboratory with the School of Medicine and Pharmacology, UWA, at the Harry Perkins Institute in Perth. Clinically, she overseas the Drug Allergy Services at two tertiary hospitals. She is the elected chair of the Australian Society of Clinical Immunology and Allergy(ASCIA) Drug Allergy working party and is the project leader for Drug Allergy for the National Allergy Strategy.
Allergic reactions to antibiotics in children are frequently reported (5-10.2%) in international studies. However, after careful evaluation, less than 10% of those with a suspected allergy are confirmed as truly allergic. In fact, drug allergy in children is approximately 1.5 times less likely to be confirmed than in adults. Nevertheless, as there is a true underlying level of life-threatening antibiotic allergy present within the labelled population, appropriate assessment is warranted. Avoiding beta-lactam antibiotics in adult patients with alleged allergy often necessitates prescription of second-line antibiotics, which may be less effective, leading to higher rates of adverse effects, emergence of multi-drug resistance (MDR) pathogens and increased hospital admissions. Data in this regards for children are missing, but our preliminary local data for children demonstrates a significant relationship between being labelled beta-lactam allergic and longer length of hospital stay (p<0.0309). Current strategies of antibiotic de-labelling are time-intensive, poorly validated and likely to differ between adults and children. This presentation will summarise the latest evidence in this area, including the most recent adverse drug reaction (ADR) classification and management strategies for IgE and non-IgE mediated ADRs in children.