![]() ![]() The data reviewed suggest that avoidance of other beta-lactams in patients with type 1 hypersensitivity to penicillins should be reconsidered.īeta-lactam cross-reactivity hypersensitivity penicillin. ![]() Cross-reactivity with monobactams is essentially negligible however, there are some clinical data to support an interaction between ceftazidime and aztreonam, due to the similarity of their side chains. Similarities in penicillin and cephalosporin side chains may play a role in cross-reactivity between these classes. (See 'Allergy evaluation for immediate penicillin allergy: Skin test-based diagnostic strategies and cross-reactivity with other beta-lactam. More recent prospective studies suggest that the rates of cross-reactivity with cephalosporins and carbapenems are <5% and <1%, respectively. The detailed allergy evaluation of a patient with past penicillin reaction based upon penicillin skin testing and studies of cross-reactivity among beta-lactam antibiotics are reviewed elsewhere. Conversely, the use of monobactam antibiotics is frequently employed in the case of a penicillin allergy, as prescribers believe that there is no cross-reactivity between the 2 drug classes. There is a wide variety in reported incidences of cross-reactivity between penicillins and cephalosporins or carbapenems, with early retrospective studies suggesting up to 41.7% and 47.4% cross-reactivity, respectively. A MEDLINE search was conducted from 1950 to October 2013, and selected references from review articles were also evaluated. This review evaluates the available data on immunoglobulin E-mediated penicillin hypersensitivity and cross-reactivity with cephalosporin, carbapenem, and monobactam antibiotics. Penicillin is the most frequently reported cause of drug allergy, and cross-reactivity of penicillins with other beta-lactam antibiotics is an area of debate. ![]()
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