These results indicate that the risk of suffering from an allergic reaction on administering cephalosporins to penicillin-allergic patients seems to be very low, provided that cephalosporins with a different side chain to the penicillin responsible for the allergic reaction are used. All penicillin-allergic patients tolerated therapeutic doses of the three cephalosporins tested (cephazoline, cefuroxime and ceftriaxone) without any ill effect. Same side chain - clinical evidence of cross reaction. True allergic, type I reactions are IgE mediated, with a spectrum of presentation ranging from urticaria. 1, 2 The cross-reactivity to cephalosporins has been reported to be approximately 8 to 18 in patients with a documented penicillin allergy. Cross-reactivity between penicillins and ALL 3rd and 4th generation cephalosporins is negligible. Cross-reactivity between penicillins and MOST 1st and 2nd generation cephalosporins is negligible.
#PENICILLIN CEPHALOSPORIN CROSS REACTIVITY SKIN#
Skin prick and intradermal tests with all cephalosporins tested were negative. of patients are labeled with a penicillin allergy and 2 with a cephalosporin allergy. A true allergy to penicillin is known to occur in less than 10 of patients exposed to penicillin. The true incidence of an allergy to penicillin in patients believed to have such allergy is <10 (it’s like we have a built in 10-fold safety factor). To assess the clinical tolerance to cephalosporins, 41 well-characterized penicillin allergic patients diagnosed by positive skin tests and/or provocation tests were challenged with three cephalosporins that do not share the same side chain to the penicillin that induced the reactions: cephazoline, cefuroxime and ceftriaxone. The diagnosis of penicillin allergy was made by positive skin tests to penicillin reagents and/or provocation tests with the penicillin suspected of causing the allergic reaction.
The purpose of this study was to assess the safety of administering cephalosporins to penicillin-allergic patients. There are some contradicting data about clinical allergic cross-reactivity to cephalosporins among patients who have had a previous allergic reaction to penicillins.
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