Drug Allergy Labels in Children: A Growing Concern and Path to Solutions
Milwaukee, February 13, 2026 – New research presented at the 2026 AAAAI Annual Meeting highlights a critical issue in pediatric care: the widespread prevalence of unverified drug allergy labels (DALs) in children with primary immunodeficiencies. These labels, often stemming from reactions that may not be true allergies, can significantly impact treatment options and patient outcomes.
The Problem with Unnecessary Allergy Labels
According to the study, nearly 50% of children with primary immunodeficiencies have at least one drug allergy label. This is particularly concerning as these patients often require frequent antibiotic treatment. Unconfirmed allergies can lead to longer hospital stays, increased readmission rates, and the use of broader-spectrum antibiotics – potentially exacerbating antibiotic resistance.
Dr. Christine R. Rukasin, MD, FAAAAI, of Phoenix Children’s, emphasizes the anxiety these labels create for families. “Drug reactions can be scary, particularly for children with primary immunodeficiencies who have a higher need for antibiotics,” she stated. “Many children in this population carry antibiotic allergy labels, and of those who underwent formal evaluation the majority were delabeled.”
Antibiotic Allergies: A Closer Gaze
The research specifically examined the types of allergies reported. Antibiotics accounted for 43.4% of all DALs, with penicillin being the most common (16.4%), followed by cephalosporins (8.0%), vancomycin (6.6%), and trimethoprim/sulfamethoxazole (4.0%).
The Low Rate of Formal Allergy Evaluation
Despite the potential risks, a surprisingly slight percentage of patients receive formal allergy evaluations. The study found that only 18.9% of patients with a DAL were referred to an allergist/immunologist for testing. However, of those who *did* undergo evaluation, a significant 85% were successfully “delabeled,” meaning their allergy was determined to be unfounded.
Implications for Future Pediatric Care
This research underscores the urgent need for increased allergy evaluation in children with primary immunodeficiencies. Proactive delabeling can not only improve antibiotic stewardship but also enhance the safety and effectiveness of pediatric care.
The American Academy of Allergy, Asthma & Immunology (AAAAI) offers resources on penicillin allergy delabeling at aaaai.org.
FAQ
Q: What is a drug allergy label (DAL)?
A: A drug allergy label is a notation in a patient’s medical record indicating a reported allergic reaction to a specific medication.
Q: Why are DALs a concern?
A: Unverified DALs can limit treatment options, lead to the use of less effective antibiotics, and potentially worsen patient outcomes.
Q: What is “delabeling”?
A: Delabeling refers to the process of formally evaluating a suspected allergy and determining that it is not a true allergy, allowing the medication to be safely used in the future.
Q: What percentage of patients with a DAL were successfully delabeled in this study?
A: 85% of patients who underwent formal allergy evaluation were successfully delabeled.
Did you understand? A formal allergy evaluation can significantly improve a patient’s treatment options and quality of life.
Pro Tip: If you or your child has a suspected drug allergy, discuss formal allergy testing with your healthcare provider.
Learn more about the research presented at the 2026 AAAAI Annual Meeting in Philadelphia, PA, February 27 – March 2.
Have questions about drug allergies? Share your thoughts in the comments below!
