Cross-allergenicity with cephalosporins

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%. 

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... 

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

Assume complete cross-allergenicity between individual cephalosporins and partial cross-allergenicity with penicillins (about 5%)... 

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. 

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 ... 

Allergenicity is less commonly experienced and is less severe with cephalosporins than with penicillins. Cephalosporins frequently are administered to patients who have had a mild or delayed penicillin reaction. Cross-allergenicity is comparatively common, however, and cephalosporins should be administered with caution for patients who have a history of allergies. Patients who have had a rapid and severe reaction to penicillins should not be treated with cephalosporins. 

Immune cross-reactivity of benzylpenicillin and ceph-alothin was reported.23 cross-allergenicity to penicillins and cephalorsporins was noted.23 in contrast, in a study on the allergenicity and toxicity of cephaloridlne and ceph-alothin, no cross-allergy with the penicillins was observed.27 An orally effective cephalosporin, e.. cephalexin, as well as oral penicillins, would appear to have greatly less sensitizing potential than those given by injection. 

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