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Use of cephalosporins in patients with positive skin tests to penicillin

Use of cephalosporins in patients with positive skin tests to penicillin
Study Number of patients Number of reactions (%) Cephalosporin skin testing Comment
Girard (1968)[1] 23 2 (8.7) No Both reactions to cephaloridine
Assem (1974)[2] 3 3 (100) No All reactions to cephaloridine
Warrington (1978)[3] 3 0 Yes  
Solley (1982)[4] 27 0 No  
Saxon (1987)[5] 62 1 (1.6) No Cephalosporin not noted
Blanca (1989)[6] 16 2 (12.5) No Both reactions to cefamandole
Shepherd (1993)[7] 9 0 No  
Audicana (1994)[8] 12 0 Yes  
Pichichero (1998)[9] 39 2 (5.1) No Reaction to cefaclor and ?
Novalbos (2001)[10] 23 0 Yes  
Macy (2002)[11] 42 1 (2.4) No Reaction to cefixime
Romano (2004)[12] 75 0 Yes  
Greenberger (2005)[13] 6 0 No  
Park (2010)[14] 85 2 (2.4) No Reactions to cefazolin, cephalexin
Ahmed (2012)[15] 21  0  No   
Total 446 13 (2.9)    
Summary of penicillin skin test-positive patients challenged with cephalosporins, excluding patients selectively allergic to amoxicillin or ampicillin (skin test-positive to an aminopenicillin, but negative to penicillin G-derived major and minor determinants).
References:
  1. Girard JP. Common antigenic determinants of penicillin G, ampicillin and the cephalosporins demonstrated in men. Int Arch Allergy Appl Immunol 1968; 33:428.
  2. Assem ES, Vickers MR. Tests for penicillin allergy in man. II. The immunological cross-reaction between penicillins and cephalosporins. Immunology 1974; 27:255.
  3. Warrington RJ, Simons FE, Ho HW, Gorski BA. Diagnosis of penicillin allergy by skin testing: the Manitoba experience. Can Med Assoc J 1978; 118:787.
  4. Solley, GO, Gleich GJ, Van Dellen RG. Penicillin allergy: Clinical experience with a battery of skin-test reagents. J Allergy Clin Immunol 1982; 69:238.
  5. Saxon A, Beall GN, Rohr AS, Adelman DC. Immediate hypersensitivity reactions to beta-lactam antibiotics. Ann Intern Med 1987; 107:204.
  6. Blanca M, Fernandez J, Miranda A, et al. Cross-reactivity between penicillins and cephalosporins: Clinical and immunologic studies. J Allergy Clin Immunol 1989; 83:381.
  7. Shepherd GM, Burton DA. Administration of cephalosporin antibiotics to patients with a history of penicillin allergy. J Allergy Clin Immunol 1993; 91:262
  8. Audicana M, Bernaola G, Urrutia I, et al. Allergic reactions to betalactams: studies in a group of patients allergic to penicillin and evaluation of cross-reactivity with cephalosporin. Allergy 1994; 49:108.
  9. Pichichero ME, Pichichero DM. Diagnosis of penicillin, amoxicillin, and cephalosporin allergy: reliability of examination assessed by skin testing and oral challenge. J Pediatr 1998; 132:137.
  10. Novalbos A, Sastre J, Cuesta J, et al. Lack of allergic cross-reactivity to cephalosporins among patients allergic to penicillins. Clin Exp Allergy 2001; 31:438.
  11. Macy E, Burchette RJ. Oral antibiotic adverse reactions after penicillin skin testing: multi-year follow-up. Allergy 2002; 57:1151.
  12. Romano A, Guéant-Rodriguez RM, Viola M, et al. Cross-reactivity and tolerability of cephalosporins in patients with immediate hypersensitivity to penicillins. Ann Intern Med 2004; 141:16.
  13. Greenberger PA, Klemens JC. Utility of penicillin major and minor determinants for identification of allergic reactions to cephalosporins. J Allergy Clin Immunol 2005; 115:S182
  14. Park MA, Koch CA, Klemawesch P, et al. Increased adverse drug reactions to cephalosporins in penicillin allergy patients with positive penicillin skin test. Int Arch Allergy Immunol 2010; 153:268.
  15. Ahmed KA, Fox SJ, Frigas E, Park MA. Clinical outcome in the use of cephalosporins in pediatric patients with a history of penicillin allergy. Int Arch Allergy Immunol 2012; 158:405.
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