Allergy, beta lactams

Allergic bronchospasm can principally be a consequence of IgE antibody-mediated allergy to all beta-lactam antibiotics. 

Lee D, Dewdney JM, Edwards RG, Neftel KA, Walti M. Measurement of specific IgG antibody levels in serum of patients on regimes comprising high total dose beta-lactam therapy. Int Arch Allergy Appl Immunol 1986 79(4) 344-8. 

Adkinson NF Jr. Beta-lactam crossreactivity. Clin Exp Allergy 1998 28(Suppl 4) 37 0. 

Shepherd GM. Allergy to beta-lactam antibiotics. Immunol Allergy Clin North Am I991 11 6II. 

Edwards RG, Dewdney JM, Dobrzanski RJ, Lee D. Immunogenicity and allergenicity studies on two beta-lactam structures, a clavam, clavulanic acid, and a carbape-nem structure-activity relationships. Int Arch Allergy Appl Immunol 1988 85(2) 184-9. 

Vega JM, Blanca M, Carmona MJ, Garcia J, Claros A, Juarez C, Moya MC. Delayed allergic reactions to beta-lactams. Four cases with intolerance to amoxicillin or ampicillin and good tolerance to penicillin G and V. Allergy 1991 46(2) 154-7. 

Wickern GM, Nish WA, Bitner AS, Freeman TM. Allergy to beta-lactams a survey of current practices. J Allergy ain Immunol 1994 94(4) 725-31. 

Sullivan TJ, Yecies LD, Shatz GS, Parker CW, Wedner HJ. Desensitization of patients allergic to penicillin using orally administered beta-lactam antibiotics. J Allergy Clin Immunol 1982 69(3) 275-82. 

Rodriguez-Pena R, Lopez S, Mayorga C, AntunezC, Fernandez TD, Torres MJ, Blanca M Potential Involvement of dendritic cells in delayed-type hypersensitivity reactions to beta-lactams. J Allergy Clin Immunol 2006 118 949-56. 

C Ciprofloxacin is the best choice due to its good penetration into the prostate. Although TMP-SMX also has good penetration into the prostate, it should be avoided due to his allergy to sulfa medications. Beta-lactams and nitrofurantoin are not used for prostatitis because they do not adequately penetrate into the prostate. 

Note Penicillin and cephalosporins share a common beta-lactam structure. People who are allergic to penicillin are approximately 4 times more likely to develop an allergic reaction to a cephalosporin than those people who have no penicillin allergy. (From 5 to 16% of patients allergic to penicillin develop reactions to cephalosporins)... 

Weiss ME, Adkinson NF. Beta-lactam allergy. In Mandell GL, Benneh JE, Dolin R, eds. Principles and Practice of Infectious Diseases, 5th ed. New York, Churchill-Livingstone, 2000 299-305. 

Ros o, N. A., Grumach, A. S. (2006 Nov). Allergy to beta-lactams in pediatrics A practical approach. Jornal de Pediatria, 82 5 Suppl.), S181AS188. 

Solensky, R (2003 Jun). Hypersensitivity reactions to beta-lactam antibiotics. Clinical Reviews in Allergy 6 Immunology, 24 S), 201—220. 

First-generation cephalosporin prototype bactericidal beta-lactam inhibitor of cell wall synthesis. Active against gram-positive cocci, E coli, K pneumoniae. but does not enter CSF. Tox potential allergy partial cross-reactivity with penicillins. 

Contraindications Use with caution witb clients with allergy to imipenem, cUastin or otber beta-lactams. Kidney problems require a reduced dosage. More than 2 g daily increase the risk for seizures... 

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