Cross-allergenicity

N-4 position and a substituted ring at the N-l position. Because of this different chemical structure, cross-allergenicity with the other sulfonamides may not occur. However, because this has not been well studied, if a patient has a reaction to a sulfonamide antibiotic, whether or not he or she will have a reaction to these other sulfonamides remains controversial. Predisposition to allergic reactions is a more likely reason than cross-reactivity between these differing molecules.14 The sulfonamide antibiotics are significant because they account for the largest percentage of antibiotic-induced toxic epidermal necrolysis and Stevens-Johnson syndrome cases.15... 

Cross allergenicity Sensitivity to one drug that results in reaction to a different drug with a similar chemical structure. 

Sulfa drugs Cross-allergenicity with other sulfa drugs and with... 

Cross-allergenicity with cephalosporins Individuals with a history of penicillin hypersensitivity have experienced severe reactions when treated with a cephalosporin. The incidence of cross-allergenicity between penicillins and cephalosporins is estimated to range from 5% to 16% however, it is possible the incidence is much lower, possibly 3% to 7%. 

Cross-allergenicity with penicillin Administer cautiously to penicillin-sensitive patients. There is evidence of partial cross-allergenicity cephalosporins cannot be assumed to be an absolutely safe alternative to penicillin in the penicillin-allergic patient. The estimated incidence of cross-sensitivity is 5% to 16% however, it is possibly as low as 3% to 7%. 

Cross-allergenicity Cross-allergenicity among the aminoglycosides has been demonstrated. 

Cephalosporins Cross-allergenicity Contraindicated in patients with history of anaphylaxis to penicillins Disulfiram-like reaction with ethanol... 

Cephalosporins are sensitizing and may elicit a variety of hypersensitivity reactions that are identical to those of penicillins, including anaphylaxis, fever, skin rashes, nephritis, granulocytopenia, and hemolytic anemia. However, the chemical nucleus of cephalosporins is sufficiently different from that of penicillins so that some individuals with a history of penicillin allergy may tolerate cephalosporins. The frequency of cross-allergenicity between the two groups of drugs is uncertain but is probably around 5-10%. However, patients with a history of anaphylaxis to penicillins should not receive cephalosporins. 

Aztreonam Prevents bacterial cell wall synthesis by binding to and inhibiting cell wall transpeptidases Rapid bactericidal activity against susceptible bacteria Infections caused by aerobic, gram-negative bacteria in patients with immediate hypersensitivity to penicillins IV administration renal clearance half-life 1.5 h dosed every 8 h Toxicity No cross-allergenicity with penicillins... 

All sulfonamides, including antimicrobial sulfas, diuretics, diazoxide, and the sulfonylurea hypoglycemic agents, have been considered to be partially cross-allergenic. Flowever, evidence for this is not extensive. The most common adverse effects are fever, skin rashes, exfoliative dermatitis, photosensitivity, urticaria, nausea, vomiting, diarrhea, and difficulties referable to the urinary tract (see below). Stevens-Johnson syndrome, although relatively uncommon (ie, < 1% of treatment courses), is a particularly serious and potentially fatal type of skin and mucous membrane eruption associated with sulfonamide use. Other unwanted effects include stomatitis, conjunctivitis, arthritis, hematopoietic disturbances (see below), hepatitis, and, rarely, polyarteritis nodosa and psychosis. 

Glucosamine sulfate is very well tolerated. In clinical trials, mild diarrhea and nausea were occasionally reported. Cross allergenicity in people with shellfish allergies is a potential concern however, this is unlikely if the formulation has been properly manufactured and purified. 

Bemhisel-Broadbent, J. and Sampson, H.A. 1989. Cross-allergenicity in the legume botanical family in children with food hypersensitivity. J Allergy Clin Immunol 83 435 440. 

Lifrani, A., Dubarry, M., Rautureau, M., Aattouri, N., Boyaka, P.N., and Tome, D. 2005. Peanut-lupine antibody cross-reactivity is not associated to cross-allergenicity in peanut-sensitized mouse strains. Int Immunopharmacol 5 1427-1435. 

Abraham GN, Petz LD, Fudenberg HH. Immunohaematological cross-allergenicity between penicilhn and cephalothin in humans. Clin Exp Immunol 1968 3(4) 343-57. 

Adkinson NF Jr. Immunogenicity and cross-allergenicity of aztreonam Am J Med 1990 88(3C) S12-5 discussion S38M2. 

Like penicillins, cephalosporins are a relatively nontoxic group of antibiotics. The primary adverse effect reported is hypersensitivity, a rare event. Cross-allergenicity with penicillins may occur. Toxicity is unlikely in children less than 6 years of age who acutely ingest less than 250 mg kg Nephrotoxicity is a possible, but rare, occurrence with acute ingestion. Coagulopathies have been reported following chronic intravenous use of certain cephalosporins. At higher... 

Assume complete cross-allergenicity between individual penicillins. 

GI distress, drug fever (partial cross-allergenicity with penicillins), CNS effects, including seizures with imipenem in OD or renal dysfunction. 

IV drug mainly active versus gram-negative rods. No cross-allergenicity with penicillins or cephalosporins. 

Hypersensitivity, mostly rashes, which can be severe (Stevens-Johnson syndrome). Assume complete cross-allergenicity between sulfonamides and possibly with sulfonylurea hypo-glycemics. 

However, they increase prothrombin time (PT) when used with warfarin and may possibly exert prothombotic effects via inhibition of endothelial cell function. Celecoxib is cross-allergenic with sulfonamides. Potential cardiotoxicity ... 

Hypersensitivity reactions (2% incidence) wide range, but rashes and drug fever most common, positive Coombs test, but rarely hemolysis. Assume complete cross-allergenicity between individual cephalosporins and partial cross-hypersensitivity with penicillins (about 5%). Most authorities recommend voiding (iTffl S()[ >1.cephalosporins in patients allergic to penicillins (tor gram-positive organism ... 

---