Hypersensitivity to cefuroxime with good tolerance to other betalactams

A 60-year-old man developed an anaphylactic reaction immediately after administration of intramuscular sodium cefuroxime. By means of oral controlled challenge, the reaction was reproduced with a smaller dose of cefuroxime axetil. Cross-reactivity with other betalactam antibiotics was ruled out by in vivo tests. This case supports once again the relevance of the side-chain in betalactam allergy.