However, allergic reactions to cephalosporin antibiotics may occur in non-penicillin-allergic patients and are then related to determinants unique to the structure of the specific cephalosporin.
Penicillin allergy cross reactivity skin#
Consequently, penicillin skin testing is also recommended in the evaluation of cephalosporin allergy to identify those patients that are allergic to the common β-lactam ring. Since the degradation of penicillin into the major and minor determinants is well described, skin testing that includes these degradation products is considered the most reliable tool for diagnosing IgE-mediated penicillin allergy. The estimated risk of developing an allergic reaction with cephalosporins ranges from 1 to 3% and is even higher in patients with documented penicillin allergy, because of the known crossreactivity related to the β-lactam ring, which is shared by both the penicillins and cephalosporins. After the penicillins, they are the most common antibiotics to induce severe or life-threatening IgE-mediated reactions. Cephalosporins without side chain similarities are suggested to patients with cephalosporin reactions and no β-lactam reactivity.Ĭephalosporin antibiotics are widely used for the treatment of common pediatric and adult infections. Conclusion: A positive skin test to cephalosporin implies the presence of drug-specific IgE antibodies. In 96.9% of the oral challenges, which were done using medications with no structural side chain similarities to the culprit drug, no adverse reaction occurred. In 4 patients, skin tests included the causative drug in 2 patients, the diagnosis of a cephalosporin allergy was made by skin test in 4 patients, the diagnosis of a cephalosporin hypersensitivity was made by oral challenge. A total of 42 skin tests and 20 oral challenges were performed. If indicated, oral challenge testing was performed. Methods: The patients were assessed by skin tests with the culprit cephalosporin as well as with other cephalosporins and penicillins. In this study, we wish to describe a group of non-penicillin-allergic patients who were evaluated for immediate allergic reactions to cephalosporins. Background: Cephalosporins can induce severe or life-threatening IgE-mediated reactions in some individuals.
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