| The Use of Cephalosporins in Penicillin-allergic Patients: A Literature Review. | |
| | |
MedLine Citation:
|
PMID: 21742459 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: The practice of avoiding cephalosporin administration to penicillin-allergic patients persists despite the low rate of cross reactions between both groups of antibiotics. OBJECTIVE: The purpose of this literature review is to evaluate the published evidence regarding the commonly held belief that patients with a history of an allergic reaction to penicillin have a significantly increased risk of an allergic reaction to cephalosporins. MATERIALS AND METHODS: Articles were identified through a computerized search of MEDLINE from 1950 to the present using the search terms "penicillin$," "cephalosporin$," "allerg$," "hypersensitivity," and "cross-react$." All articles were reviewed, and additional sources cited in them were added to the literature review. RESULTS: Penicillins have a cross allergy with first-generation cephalosporins (odds ratio 4.8; confidence interval 3.7-6.2) and a negligible cross allergy with second-generation cephalosporins (odds ratio 1.1; confidence interval 0.6-2.1). Laboratory and cohort studies confirm that the R1 side chain is responsible for this cross reactivity. Overall cross reactivity between penicillins and cephalosporins is lower than previously reported, though there is a strong association between amoxicillin and ampicillin with first- and second-generation cephalosporins that share a similar R1 side chain. CONCLUSIONS: Although a myth persists that approximately 10% of patients with a history of penicillin allergy will have an allergic reaction if given a cephalosporin, the overall cross-reactivity rate is approximately 1% when using first-generation cephalosporins or cephalosporins with similar R1 side chains. However, a single study reported the prevalence of cross reactivity with cefadroxil as high as 27%. For penicillin-allergic patients, the use of third- or fourth-generation cephalosporins or cephalosporins with dissimilar side chains than the offending penicillin carries a negligible risk of cross allergy. |
| | |
Authors:
|
James D Campagna; Michael C Bond; Esteban Schabelman; Bryan D Hayes |
Related Documents
:
|
21147379 - Positron emission tomography-computed tomography reporting in radiation therapy plannin... 21228719 - Immune-mediated coagulopathy associated with topical bovine thrombin: review of the ped... 17453089 - Progressive pseudorheumatoid chondrodysplasia of childhood. 19484249 - Psammomatoid ossifying fibroma with secondary aneurysmal bone cyst of frontal sinus. 6944679 - Paraoral cartilage analogue of fibromatosis. 21493409 - Extracts from the cochrane library: sublingual immunotherapy for allergic rhinitis. 20953729 - Interventions encouraging the use of systematic reviews in clinical decision-making: a ... 19527519 - Necrotizing fasciitis of the lower extremity: a case report and current concept of diag... 10155419 - Liability immunity as a legal defense for recent emergency medical services system liti... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-7-8 |
Journal Detail:
|
Title: The Journal of emergency medicine Volume: - ISSN: 0736-4679 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
|
Created Date: 2011-7-11 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8412174 Medline TA: J Emerg Med Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Chronic Malnutrition May In Fact Be an Acute emergency.
Next Document: A systematic review of interventions for co-occurring substance use disorder and borderline personal...