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IgE-mediated hypersensitivity to cephalosporins: cross-reactivity and tolerability of penicillins, monobactams, and carbapenems.
Open accessAbstract
Background There have been few studies regarding the cross-reactivity and tolerability of penicillins, aztreonam, and carbapenems in large samples of subjects with cephalosporin allergy.Objective We sought to evaluate the possibility of using penicillins, monobactams, and carbapenems in subjects with cephalosporin allergy who especially require them.Methods We conducted a prospective study of 98 consecutive subjects who had 106 immediate reactions (mostly anaphylactic shock) to cephalosporins and had positive skin test results for these drugs. To assess the cross-reactivity with penicillins, monobactams, and carbapenems and the tolerability of such alternative β-lactams, all subjects underwent skin tests and serum-specific IgE assays with penicillin reagents, as well as skin tests with aztreonam, imipenem/cilastatin, and meropenem. Subjects with negative test results were challenged with meropenem, imipenem/cilastatin, aztreonam, and amoxicillin.Results Positive allergologic test results to penicillins were displayed by 25 (25.5%) subjects, including 1 with positive results to all reagents tested and another with a positive result to aztreonam. Another subject had positive results to both ceftazidime and aztreonam. A reaction to cephalosporins with side-chain structures similar or identical to those of penicillins was a significant predictor of cross-reactivity because of an increased 3-fold risk of positive results on allergologic tests with penicillin determinants. Challenges with alternative β-lactams were tolerated, with the exception of 1 urticarial reaction to imipenem/cilastatin.Conclusions About 25% of subjects with cephalosporin allergy had positive results to penicillins, 3.1% to aztreonam, 2% to imipenem/cilastatin, and 1% to meropenem. In those who especially require alternative β-lactams, pretreatment skin tests are advisable because negative results indicate tolerability of the β-lactam concerned.
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“Allergic reactions with third-generation cephalosporins (e.g., ceftriaxone) are uncommon among persons with a history of penicillin allergy (620,631,658,896).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [896]
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Citations
Cites
Baltosser, W. H., & Zar, J. H. (1996) · Ecology · doi:10.2307/2265725 · Cited by 35,166
Biostatistical Analysis (2nd ed.).
Breen, T. J., & Zar, J. H. (1986) · Journal of the American Statistical Association · doi:10.2307/2289268 · Cited by 5,792
Sampson, H. A., Muñoz-Furlong, A., Campbell, R. L., Adkinson, N., Bock, S. A., Branum, A., Brown, S., Camargo, C. A., Cydulka, R., Galli, S., et al. (2006) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2005.12.1303 · Cited by 2,170
General considerations for skin test procedures in the diagnosis of drug hypersensitivity
Brockow, K., Romano, A. G., Blanca, M., Ring, J., Pichler, W. J., & Demoly, P. M. (2002) · Allergy · doi:10.1046/j.0105-4538.2001.00001.x-i8 · Cited by 753
Variation in antibiotic use in the European Union
Cars, O., Mölstad, S., & Melander, A. (2001) · The Lancet · doi:10.1016/s0140-6736(00)04972-2 · Cited by 698
Symposium on the definition and management of anaphylaxis: summary report.
Sampson, H., Muñoz-Furlong, A., Bock, S., Schmitt, C., Bass, R., Chowdhury, B., Decker, W., Furlong, T., Galli, S., Golden, D., et al. (2005) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2005.01.009 · Cited by 640
European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe
Ferech, M., Coenen, S., Malhotra‐Kumar, S., Dvorakova, K., Hendrickx, E., Suetens, C., & Goossens, H. (2006) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkl188 · Cited by 598
Diagnosis of immediate allergic reactions to beta‐lactam antibiotics
Torres, M. J., Blanca, M., Fernández, J., Romano, A. G., Weck, A. D., Aberer, W., Brockow, K., Pichler, W. J., Demoly, P. M., for, E. N. D. A., et al. (2003) · Allergy · doi:10.1034/j.1398-9995.2003.00280.x · Cited by 527
Update on the evaluation of hypersensitivity reactions to betalactams
Blanca, M., Romano, A. G., Torres, M. J., Fernández, J., Mayorga, C., Rodriguez, J., Demoly, P. M., Bousquet, P., Merk, H. F., Sanz, M. L., et al. (2009) · Allergy · doi:10.1111/j.1398-9995.2008.01924.x · Cited by 450
Immediate Hypersensitivity Reactions to Beta-Lactam Antibiotics
Saxon, A., BEALL, G. N., ROHR, A. S., & Adelman, D. C. (1987) · Annals of Internal Medicine · doi:10.7326/0003-4819-107-2-204 · Cited by 410
Kelkar, P. S., & Li, J. T. C. (2001) · New England Journal of Medicine · doi:10.1056/nejmra993637 · Cited by 309
Romano, A. G., Valluzzi, R. L., Caruso, C., Maggioletti, M., Quaratino, D., & Gaeta, F. (2018) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2018.01.020 · Cited by 254
Pichichero, M. E. (2005) · PEDIATRICS · doi:10.1542/peds.2004-1276 · Cited by 228
Antimicrobial-Drug Prescription in Ambulatory Care Settings, United States, 1992–2000
McCaig, L. F., Besser, R. E., & Hughes, J. M. (2003) · Emerging infectious diseases · doi:10.3201/eid0904.020268 · Cited by 209
Pichichero, M. E., & Pichichero, D. M. (1998) · The Journal of Pediatrics · doi:10.1016/s0022-3476(98)70499-8 · Cited by 203
Antúnez, C., Blanca‐López, N., Torres, M. J., Mayorga, C., Pérez‐Inestrosa, E., Montañez, M. I., Fernández, T. D., & Blanca, M. (2006) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2005.10.032 · Cited by 202
Romano, A. G., Guéant‐Rodriguez, R., Viola, M., Pettinato, R., & Guéant, J. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-141-1-200407060-00010 · Cited by 184
Immediate allergic reactions to cephalosporins: Cross-reactivity and selective responses
Romano, A. G., Mayorga, C., Torres, M. J., Artesani, M. C., Suau, R., Martín‐Sánchez, F. J., Pérez, E., Venuti, A., & Blanca, M. (2000) · Journal of Allergy and Clinical Immunology · doi:10.1067/mai.2000.111147 · Cited by 175
Diagnosing nonimmediate reactions to cephalosporins
Romano, A. G., Gaeta, F., Valluzzi, R. L., Caruso, C., Alonzi, C., Viola, M., & Bousquet, P. (2012) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2011.12.995 · Cited by 163
Cross-reactivity between a penicillin and a cephalosporin with the same side chain
Miranda, A., Blanca, M., Vega, J. M., Moreno, F., Carmona, M. J., García, J. J., Segurado, E., JUSTICIA, J., & Juarez, C. (1996) · Journal of Allergy and Clinical Immunology · doi:10.1016/s0091-6749(96)70101-x · Cited by 158
Audicana, M. T., Bernaola, G., Urrutia, I., Echechipia, S., Gastaminza, G., Muñoz, D., Fernández, E., & de Corrés, L. F. (1994) · Allergy · doi:10.1111/j.1398-9995.1994.tb00809.x · Cited by 151
Lack of allergic cross-reactivity to cephalosporins among patients allergic to penicillins.
Novalbos, A., Sastre, J., Cuesta, J., De Las Heras, M., Lluch‐Bernal, M., Bombín, C., & Quirce, S. (2001) · Clinical & Experimental Allergy · doi:10.1046/j.1365-2222.2001.00992.x · Cited by 151
Imipenem in Patients with Immediate Hypersensitivity to Penicillins
Romano, A. G., Viola, M., Guéant‐Rodriguez, R., Gaeta, F., Pettinato, R., & Guéant, J. (2006) · New England Journal of Medicine · doi:10.1056/nejmc053529 · Cited by 137
Diagnosing immediate reactions to cephalosporins
Romano, A. G., Guéant‐Rodriguez, R., Viola, M., Amoghly, F., Gaeta, F., Nicolas, J. P., & Guéant, J. (2005) · Clinical & Experimental Allergy · doi:10.1111/j.1365-2222.2005.02317.x · Cited by 135
Romano, A. G., Viola, M., Guéant‐Rodriguez, R., Gaeta, F., Valluzzi, R. L., & Guéant, J. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-4-200702200-00005 · Cited by 130
PART 1: Executive Summary of Disease Management of Drug Hypersensitivity: A Practice Parameter
(1999) · Annals of Allergy Asthma & Immunology · doi:10.1016/s1081-1206(10)62890-6 · Cited by 120
Penicillins and cephalosporins as allergens — structural aspects of recognition and cross‐reactions
Baldo, V. (1999) · Clinical & Experimental Allergy · doi:10.1046/j.1365-2222.1999.00575.x · Cited by 117
Diagnosing Hypersensitivity Reactions to Cephalosporins in Children
Romano, A. G., Gaeta, F., Valluzzi, R. L., Alonzi, C., Viola, M., & Bousquet, P. (2008) · PEDIATRICS · doi:10.1542/peds.2007-3178 · Cited by 104
Tolerability of meropenem in children with IgE‐mediated hypersensitivity to penicillins
Atanasković‐Marković, M., Gaeta, F., Medjo, B., Viola, M., Nestorović, B., & Romano, A. G. (2008) · Allergy · doi:10.1111/j.1398-9995.2007.01532.x · Cited by 84
Side‐chain‐specific reactions to betalactams: 14 years later
Blanca, M., Mayorga, C., Torres, M. J., Warrington, R., Romano, A. G., Demoly, P. M., Silviu-Dan, F., Moya, M., Fernández, J., & Juárez, C. (2002) · Clinical & Experimental Allergy · doi:10.1046/j.1365-2222.2002.01299.x · Cited by 70
Tolerance to aztreonam in patients allergic to betalactam antibiotics
Vega, J. M., Blanca, M., García, J. J., Miranda, A., Carmona, M. J., García, A., Moya, M., Sanchez, F., & Terrados, S. (1991) · Allergy · doi:10.1111/j.1398-9995.1991.tb00570.x · Cited by 61
Tolerability of imipenem in children with IgE-mediated hypersensitivity to penicillins
Atanasković‐Marković, M., Gaeta, F., Gavrović-Jankulović, M. Đ., Veličković, T. Ć., Valluzzi, R. L., & Romano, A. G. (2009) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2009.02.031 · Cited by 59
A case of IgE-mediated hypersensitivity to ceftriaxone☆☆☆★
Romano, A. G., Quaratino, D., Venemalm, L., Torres, M. J., Venuti, A., & Blanca, M. (1999) · Journal of Allergy and Clinical Immunology · doi:10.1016/s0091-6749(99)70100-4 · Cited by 59
Pham, N. H., & Baldo, B. A. (1996) · Journal of Molecular Recognition · doi:10.1002/(sici)1099-1352(199607)9:4 · Cited by 59
Moss, R. B. (1991) · Journal of Allergy and Clinical Immunology · doi:10.1016/0091-6749(91)90215-a · Cited by 55
Tolerability of Aztreonam in Patients with IgE-Mediated Hypersensitivity to Beta-Lactams
Patriarca, G., Schiavino, D., Lombardo, C., Altomonte, G., Decinti, M., Buonomo, A., & Nucera, E. (2008) · International Journal of Immunopathology and Pharmacology · doi:10.1177/039463200802100215 · Cited by 49
Aztreonam and ceftazidime: evidence of in vivo cross‐allergenicity
Pimiento, A. P., Martínez, M. G., Mena, A., González, A. T., Arranz, S. D. P., & Mosquera, M. R. (1998) · Allergy · doi:10.1111/j.1398-9995.1998.tb03944.x · Cited by 48
Non-specific cross-reactivity of hydrophobic serum IgE to hydrophobic drugs
Guéant, J. (1995) · Molecular Immunology · doi:10.1016/0161-5890(94)00152-q · Cited by 44
Madaan, A., & Li, J. T. C. (2004) · Immunology and Allergy Clinics of North America · doi:10.1016/j.iac.2004.03.009 · Cited by 43
IgE-Mediated Hypersensitivity to Cephalosporins
Guéant, J., Guéant‐Rodriguez, R., Viola, M., Valluzzi, R. L., & Romano, A. G. (2006) · Current Pharmaceutical Design · doi:10.2174/138161206778194060 · Cited by 36
Allergy to Amoxicillin in Patients Who Tolerated Benzylpenicillin, Aztreonam, and Ceftazidime
Martín, J. A., Igea, J. M., Fraj, J., Lezaun, A., Parra, F., & Losada, E. (1992) · Clinical Infectious Diseases · doi:10.1093/clinids/14.2.592 · Cited by 35
Immediate hypersensitivity to cephalosporins
Romano, A. G., Torres, M. J., Namour, F., Mayorga, C., Artesani, M. C., Venuti, A., Guéant, J., & Blanca, M. (2002) · Allergy · doi:10.1034/j.1398-9995.57.s72.18.x · Cited by 34
Iglesias‐Cadarso, A. (1990) · The Lancet · doi:10.1016/0140-6736(90)92238-d · Cited by 25
Research works printed but not linked: 2
- Romano, 1997, Cephalosporin allergy: Characterization of unique and cross-reacting cephalosporin antigens, Int J Immunopathol Pharmacol, 10, 187
- Solensky, 2001, Systemic reactions to antibiotics, Immunol Allergy Clin North Am, 21, 479
Cited by
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Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 3,018
Sexually Transmitted Diseases Treatment Guidelines, 2010
Workowski, K., & BOLAN, G. A. (2011) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2011.04.006 · Cited by 2,074
2012 European guideline on the diagnosis and treatment of gonorrhoea in adults
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Towards a more precise diagnosis of hypersensitivity to beta‐lactams — an EAACI position paper
Romano, A. G., Atanasković‐Marković, M., Barbaud, A. M., Bircher, A. J., Brockow, K., Caubet, J., Çelík, G., Cernadas, J., Chiriac, A. M., Demoly, P. M., et al. (2019) · Allergy · doi:10.1111/all.14122 · Cited by 363
Management of allergy to penicillins and other beta‐lactams
Mirakian, R. M., Leech, S. C., Krishna, M. T., Richter, A. G., Huber, P. A. J., Farooque, S. P., Khan, N., Pirmohamed, M., Clark, A. T., & Nasser, S. M. (2015) · Clinical & Experimental Allergy · doi:10.1111/cea.12468 · Cited by 288
Metadata
- Authors
- Romano, A., Gaeta, F., Valluzzi, R. L., Caruso, C., Rumi, G., & Bousquet, P. J.
- Affiliations
- Oasi Maria SS (IT)
- Hôpital Arnaud de Villeneuve (FR)
- Corresponding author
- Romano, Antonino
- ORCID
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 126
- Issue
- 5
- Pages
- 994-999
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W2158847388
- Cited by
- 162
- References
- 48
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 7 · 2021: 6 · 2020: 17 · 2019: 13 · 2018: 13 · 2017: 17 · 2016: 9 · 2015: 11 · 2014: 16 · 2013: 15 · 2012: 8
- FWCI
- 8.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Drug-Induced Adverse Reactions
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- cephalosporin allergy, IgE-mediated hypersensitivity, cross-reactivity, penicillin, monobactams, carbapenems, aztreonam, imipenem/cilastatin, meropenem, skin testing, drug tolerance, anaphylaxis, side chain structure
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Cephalosporins, Cross Reactions, Drug Hypersensitivity, Female, Humans, Hypersensitivity, Immediate, Immunoglobulin E, Male, Middle Aged, Monobactams, Penicillins, Skin Tests, Carbapenems, Young Adult
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