Loratadine in the treatment of mosquito-bite-sensitive children

Background: Children frequently experience harmful whealing and delayed pap ules from mosquito bites. Whealing is mediated by antisaliva IgE antibodies and histamine, but the effect of antihistamines on mosquito-bite symptoms has not been evaluated in children. Methods: The effect of loratadine (0.3 mg/kg) was examined in 28 mosquito-b ite-sensitive children (aged 2-11 years). The double-blind, placebo-control led, crossover study was performed with exposure to Aedes aegypti laborator y mosquitoes. The size of the bite lesion and the intensity of pruritus (vi sual analog scale) were measured at 15 min and at 2, 6, and 24 h. Results: Loratadine decreased the size of the wheals by 45% (P < 0.001, 25 children) and accompanying pruritus by 78% (P = 0.011, 12 children) at 15 m in compared to placebo. The size of the 24-h delayed bite lesion also decre ased significantly (P = 0.004), but there was no change at 2 or 6 h. Lorata dine was well tolerated and no marked side-effects were recorded. Conclusions: This study in children shows that prophylactically given lorat adine decreases significantly the whealing and pruritus caused by mosquito bites and also reduces the size of the 24-h bite lesions. Therefore, the th erapeutic profile of loratadine extends from immediate to delayed allergic symptoms in mosquito-bite-sensitive children.