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Related Experiment Videos

Anaphylaxis after first exposure to ceftriaxone.

M R Ernst1, P J van Dijken, P J Kabel

  • 1Department of Paediatrics, St Elisabeth Hospital, Tilburg, The Netherlands.

Acta Paediatrica (Oslo, Norway : 1992)
|May 23, 2002
PubMed
Summary

A severe allergic reaction, anaphylaxis, occurred in a child minutes after the first dose of ceftriaxone. Standard allergy tests were negative, but an intravenous challenge confirmed the ceftriaxone hypersensitivity.

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Area of Science:

  • Pediatric Allergy and Immunology
  • Infectious Disease Management
  • Pharmacovigilance

Background:

  • Ceftriaxone is a common antibiotic used for severe infections.
  • Anaphylaxis is a rare but serious allergic reaction.
  • Early identification of drug hypersensitivity is crucial for patient safety.

Observation:

  • A 5-year-old boy with septic shock developed life-threatening anaphylaxis within minutes of his first intravenous ceftriaxone dose.
  • Standard allergy testing, including skin tests and IgE levels, did not indicate hypersensitivity.
  • A controlled intravenous challenge definitively confirmed ceftriaxone-induced anaphylaxis.

Findings:

  • Anaphylaxis can occur with the initial administration of ceftriaxone.
  • Standard in vitro and skin tests may fail to detect ceftriaxone hypersensitivity.

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  • In vivo challenge is a reliable method for diagnosing ceftriaxone allergy.

    • Implications:

    • Clinicians must consider the potential for anaphylaxis with first-dose ceftriaxone, even with negative initial tests.
    • Anaphylactic reactions in critically ill patients may be masked by their underlying condition.
    • Heightened awareness and diagnostic vigilance are necessary for safe antibiotic prescribing in vulnerable populations.