A Magical Potion for Children?
By Syeda Hamdani

"Mom...Look at me!" shouted 4-year-old Tahira. I saw my daughter scratching at red blotches on her face. They looked like blisters from chicken pox, but, when I looked closely, I wasn't sure. My heart throbbed-could it be scarlet fever? I felt Tahira's forehead: no fever. But, the quarter-size blotches were as itchy as poison ivy and wouldn't disappear.

I took Tahira to her pediatrician, who said that the blotches were hives, an allergic reaction to something. "She just finished taking Amoxicillin. She's never taken this medication before," I said. She gave startling news: Amoxicillin can cause allergic reactions, such as hives. Like a magical potion, this medication had whisked away Tahira's ear infection, but it had also brought problems. I'd always considered allergic reactions something other children got, not mine. For this reason, I hadn't bothered her pediatrician with questions when obtaining the prescription. Nor had I read about the subject. In short, I'd been an uninformed parent.

The scariest allergic reaction is "anaphylaxis," or allergic shock. Had her allergy been severe, my daughter would've been in danger of losing her life! About 4% of children who take Amoxicillin experience at least some of the symptoms, according to an FDA study. For instance, your child may be wheezing or have swollen lips. Then your child might lose consciousness and reach anaphylaxis. She would need an immediate injection of adrenalin, or else shock could be fatal. To prevent recurrences, she would wear an identification bracelet.

Nevertheless, Amoxicillin is a popular medication. Pediatricians recommend Amoxicillin for ear infections, as well as tonsillitis, pneumonia, and urinary tract infections. One out of four children have taken Amoxicillin in a three- year-period, according to the Agency for Healthcare Research, and the trend will likely continue.

An inexpensive antibiotic, Amoxicillin is available under various brand names: Amoxil, Polymox, Wymox, and Trimox. Unfortunately, about 30% of children, up to age twelve, have some type of mild allergic reaction to this antibiotic.

The term "allergic reaction" is easy to confuse with "side effect" from a medication, but a distinction exists. A symptom (such as headache or slight diarrhea) that causes only discomfort in your child and that may disappear even before your child finishes the medication is classified as a "side effect." A true allergic reaction, however, is the immune system's overreaction to the medication. An allergic child's body views the microorganisms that Amoxicillin produces as foreign substances and then creates allergic antibodies to fight them.

These antibodies can cause hives to appear. Hives are itchy " pale bumps that can occur in clumps and be large or small," according to Pediatrics for Parents, Issue 10. Worst of all, scratching the hives can cause them to reappear. Other allergic reactions your child may have include thrush (oral yeast infection), severe vomiting, and watery diarrhea. A combination of allergies or one allergy can appear, soon after taking the first dose of Amoxicillin. Sometimes, the reaction will appear after several doses.

Could your child be allergic to Amoxicillin? Any child who's allergic to penicillin needs to avoid Amoxicillin. Also, a child that has asthma, hay fever, or eczema has an increased risk of having an allergic reaction to this antibiotic. The same situation is true if one or both parents have any such allergies. Furthermore, if your child has kidney disease or infectious mononucleosis, she is more likely to be allergic to Amoxicillin. Don't hesitate to discuss concerns with the pediatrician before obtaining a prescription.

After beginning treatment, if your child shows possible allergic reaction to Amoxicillin, she should promptly see a pediatrician for a physical exam and a review of his or her medical history. This information will help in diagnosing the reaction as a true allergy.

A skin test for allergic reactions to all penicillins is how some pediatricians confirm if an allergy actually exists. They use a small, diluted amount of antibiotic to see if a reaction occurs. Rosemary Hallett, MD, an allergist with the UC Davis Medical Group, says, "We perform a test if the child needs only penicillin and seems to be allergic."

Once the pediatrician confirms the reaction, he can advise on proper treatments. Your child may require prescription medications. However, he will also be open to over-the-counter remedies, if they seem appropriate. For instance, calamine lotion and a non-prescription antihistamine may ease itchy hives.

Here's good news: other antibiotics are now available that can replace Amoxicillin. Cefaclor, azithromycin, and clarithromycin are some of the choices. These more expensive antibiotics are useful for Amoxicillin-allergic children.

Some children outgrow their allergy to Amoxicillin by the time they finish elementary school. Although you may have to wait several years, hope exists that this not-so-perfect potion will no longer be a problem.

Syeda is a writer in Sacramento and enjoys spending time with her children and sewing.