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[Allergy to cephalosporin antibiotics in childhood]
Marina Atanasković-Marković1, Branimir Nestorović
1University Children's Hospital, Belgrade. marinaa@eunet.yu
Insights
Determining the safety of cephalosporins in penicillin-allergic children is crucial. This study found varying frequencies of allergic reactions and cross-reactivity between cephalosporins and penicillins in pediatric patients.
Area of Science:
- Clinical Immunology
- Pharmacology
- Pediatric Allergy
Context:
- Cephalosporin antibiotics are widely prescribed for common infections and surgical prophylaxis.
- The allergenic determinants of cephalosporins are not well-defined, posing a safety concern for penicillin-allergic children.
- Accurate identification of cephalosporin allergy and cross-reactivity is essential for safe clinical practice.
Purpose:
- To determine the frequency of anaphylactic allergic reactions to cephalosporins in children.
- To investigate the cross-reactivity between cephalosporins and penicillins.
- To assess the safety of cephalosporin administration in penicillin-allergic pediatric populations.
Summary:
- A study involving 1,170 children with suspected allergies to penicillins and/or cephalosporins was conducted over eight years.
- Skin tests and single-blind, placebo-controlled challenges were used to evaluate allergic reactions.
- Anaphylactic reactions to cephalosporins ranged from 0.2% to 17%, with cross-reactivity between cephalosporins and penicillins varying from 0.1% to 14.5%.
Impact:
- Provides crucial data on the incidence of cephalosporin allergy and cross-reactivity in children.
- Informs clinical guidelines for antibiotic selection in pediatric patients with a history of penicillin allergy.
- Highlights the importance of careful evaluation of antibiotic hypersensitivity in pediatric care.
Abstract:
A particular problem is the safety of administering cephalosporins to penicillin-allergic children, because cephalosporin allergenic determinants have not been properly identified. Cephalosporin antibiotics are widely used to treat common infections and are often the first-line prophylaxis before many types of surgery. So the arm of this study is to determine the frequency of allergic reactions of anaphylactic type to cephalosporins and their cross-reactivity with penicillins. At University Children's Hospital in Belgrade a group of 1,170 children with suspected anaphylactic allergic reaction to penicillins and/or cephalosporins were tested for the last eight years. Skin tests were performed with standard concentration of penicillins and cephalosporins. In children where skin tests were negative single-blind, placebo-controlled challenges were performed. In case of positive skin tests further examinations were interrupted and the children were considered allergic to that drug. The frequency of anaphylactic allergic reactions to cephalosporins is 0.2% to 17%, and depends on cephalosporins generation. The cross-reactivity between cephalosporins and penicillins is 0.1% to 14.5%, and among cephalosporins is 0% to 11.7%.
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