Occupational contact allergy to cephalosporins

Contact sensitivity to systemically administered drugs occurs mainly among healthcare workers and is frequently caused by antibiotics. A 32-year-old nurse presented with a 1½ year history of hand dermatitis and a 2 month history of palpebral eczema, which were clearly work related. Patch tests with standard and gloves series were negative. Testing of the products commonly handled by the patient were positive for cefradine and cefazolin. Testing of other cephalosporins the patient had not come in contact with were also positive for cefuroxime, ceftriaxone, and cefotaxime. This cross-reactivity may be explained by similar molecular structures. The patient stopped preparing cephalosporin solutions for systemic administration and the lesions cleared.