D2.407 - Treating Through in Pediatric Patients: A Single-Center Experience

Mild-to-moderate cutaneous eruptions occurring during drug therapy in hospitalized children are common and often lead to discontinuation of the suspected medications. Data on treatment-continuation strategies such as treating through (TT) in the pediatric population are limited. Our objective was to describe the safety of the “treating through” approach, as well as the accompanying clinical characteristics and outcomes, in hospitalized pediatric patients who develop mild-to-moderate cutaneous eruptions during drug therapy.

Patients aged 0–18 years who were hospitalized at Ankara Bilkent City Hospital Children’s Hospital and consulted to the Pediatric Allergy and Immunology Clinic with suspected drug allergy between January 2019 and June 2025 were evaluated. Patients who had mild-to-moderate cutaneous eruptions without systemic involvement and in whom treatment was continued with the suspected drug were included in the study.

A total of 90 patients managed with treating through were included. The median age was 96.0 (3–210) months, and 60% were male. The most common suspected drug class was antibiotics (n=66, 73.3%). Among antibiotics, beta-lactams were the leading group (n=34, 37.8%). Maculopapular rash was present in 78.9% (n=71) and urticarial rash in 21.1% (n=19). Suspected drug reactions developed on the first day of treatment in 33.3% (n=30) of patients, and 74.4% (n=67) of reactions occurred within the first 6 hours after the last drug dose. With the treating through approach, 89 patients (98.9%) completed the treatment course without problems. Treatment was discontinued in only one patient due to progression of the rash during fluconazole infusion.

In hospitalized children with non-severe cutaneous eruptions, when continuation of therapy is considered necessary, the treating through approach may be successful.