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Hypersensitivity reactions to cephalosporins
Esther Moreno1, Eva Macías, Ignacio Dávila
1University Hospital of Salamanca, Department of Allergy, Paseo San Vicente 58-132, 37007 Salamanca, Spain. emrodilla@ono.com
Expert Opinion on Drug Safety
|May 9, 2008
Summary
Cephalosporin antibiotic allergies are increasing. Skin tests for cephalosporin allergy, especially with different side chains, can help predict tolerance in patients with penicillin allergy.
Area of Science:
- Pharmacology
- Immunology
- Clinical Medicine
Background:
- Cephalosporins are widely prescribed antibiotics, leading to an increase in reported allergic reactions.
- Allergic cross-reactivity between penicillins and cephalosporins is a concern, particularly in penicillin-allergic individuals.
- Defining cephalosporin-specific allergens (haptens) is challenging, complicating allergy diagnosis.
Purpose of the Study:
- To evaluate the utility of skin testing in diagnosing cephalosporin allergy.
- To assess cross-reactivity patterns between penicillins and various cephalosporin generations.
- To determine if negative skin test results can predict tolerance to cephalosporins.
Main Methods:
- Review of existing literature on cephalosporin allergy and cross-reactivity.
- Analysis of clinical data regarding skin test results in patients with suspected cephalosporin allergy.
- Comparison of cross-reactivity based on cephalosporin side-chain structures.
Main Results:
- Cross-reactivity is higher between cephalosporins with similar side chains compared to those with different side chains.
- Skin tests are valuable tools for evaluating various types of cephalosporin-induced allergic reactions.
- Negative skin test results for penicillin and dissimilar cephalosporins suggest good tolerance.
Conclusions:
- Skin testing with cephalosporins is a useful diagnostic method for allergy evaluation.
- Negative skin tests to penicillin and cephalosporins with different side chains may predict tolerance.
- Further research is needed, but these findings support using skin tests in select cases for allergy assessment.
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