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Cephalosporin cross reactivity

J A Trubiano, L J Worth, K Urbancic, T M Brown, D L Paterson, M Lucas, E Phillips
BACKGROUND: Antibiotic allergies are frequently reported and have significant impacts upon appropriate prescribing and clinical outcomes. We surveyed infectious diseases physicians, allergists, clinical immunologists and hospital pharmacists to evaluate antibiotic allergy knowledge and service delivery in Australia and New Zealand. METHODS: An online multi-choice questionnaire was developed and endorsed by representatives of the Australasian Society of Clinical Immunology and Allergy (ASCIA), Australasian Society of Infectious Diseases (ASID) and Society of Hospital Pharmacists Australia (SHPA)...
August 16, 2016: Internal Medicine Journal
A Pinho, I Coutinho, A Gameiro, M Gouveia, M Gonçalo
BACKGROUND: Antibiotics are among the most frequent causes of cutaneous adverse drug reactions (CADR); patch testing may be an important tool in their evaluation and management. We assessed the role of patch testing as a diagnostic tool in non-immediate CADR to antibiotics, and evaluated cross-reactivity among them. METHODS: We reviewed data from all patients with non-immediate CADR attributed to antibiotics, which were patch tested between 2000 and 2014 at our dermatology department...
August 1, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Astrid P Uyttebroek, Ine I Decuyper, Chris H Bridts, Antonino Romano, Margo M Hagendorens, Didier G Ebo, Vito Sabato
BACKGROUND: Correct diagnosis of cefazolin hypersensitivity is not straightforward, mainly because of the absence of in vitro tests and uncertainties concerning the optimal cefazolin concentration for skin testing. Cross-reactivity studies suggest cefazolin hypersensitivity to be a selective hypersensitivity. OBJECTIVE: The first objective was to confirm that the application of a higher than 2 mg/mL test concentration could increase skin test sensitivity. A second part aimed at investigating the cross-reactivity between cefazolin and other β-lactam antibiotics...
June 14, 2016: Journal of Allergy and Clinical Immunology in Practice
Valentina Donà, Sara Kasraian, Agnese Lupo, Yuvia N Guilarte, Christoph Hauser, Hansjakob Furrer, Magnus Unemo, Nicola Low, Andrea Endimiani
Resistance to antibiotics used against Neisseria gonorrhoeae infections is a major public health concern. Antimicrobial resistance (AMR) testing relies on time-consuming culture-based methods. Development of rapid molecular tests for detection of AMR determinants could provide valuable tools for surveillance and epidemiological studies and for informing individual case management. We developed a fast (<1.5-h) SYBR green-based real-time PCR method with high-resolution melting (HRM) analysis. One triplex and three duplex reactions included two sequences for N...
August 2016: Journal of Clinical Microbiology
Christina Caplinger, Garret Smith, Richard Remington, Karl Madaras-Kelly
Allergies to β-lactam antibiotics are commonly documented in hospitalized patients; however, true allergy is uncommon. Cross-reactivity rates for advanced generation cephalosporins and carbapenems are low; particularly for patients without a history of symptoms consistent with type 1 hypersensitivity. We observed that providers preferentially prescribed antipseudomonal carbapenems (APC) over advanced generation cephalosporins for patients with β-lactam allergy history, including those with low risk for antimicrobial-resistant infections...
2016: Antibiotics
Antonino Romano, Francesco Gaeta, Rocco Luigi Valluzzi, Michela Maggioletti, Cristiano Caruso, Donato Quaratino
BACKGROUND: The few studies performed in adults with T cell-mediated hypersensitivity to penicillins have found a rate of cross-reactivity with cephalosporins ranging from 2.8% to 31.2% and an absence of cross-reactivity with aztreonam. OBJECTIVE: We sought to evaluate the possibility of using cephalosporins and aztreonam in subjects with documented delayed hypersensitivity to penicillins who especially require them. METHODS: We conducted a prospective study of 214 consecutive subjects who had 307 nonimmediate reactions to penicillins (almost exclusively aminopenicillins) and had positive patch test and/or delayed-reading skin test responses to at least 1 penicillin reagent...
July 2016: Journal of Allergy and Clinical Immunology
Antonino Romano, Francesco Gaeta, Maria Francisca Arribas Poves, Rocco Luigi Valluzzi
Penicillins and cephalosporins are the major classes of beta-lactam (BL) antibiotics in use today and one of the most frequent causes of hypersensitivity reactions to drugs. Monobactams, carbapenems, oxacephems, and beta-lactamase inhibitors constitute the four minor classes of BLs. This review takes into account mainly the prospective studies which evaluated cross-reactivity among BLs in subjects with a well-demonstrated hypersensitivity to a certain class of BLs by performing allergy tests with alternative BLs and, in case of negative results, administering them...
March 2016: Current Allergy and Asthma Reports
Richard H Epstein, Paul St Jacques, Jonathan P Wanderer, Mark R Bombulie, Niraj Agarwalla
We studied prophylactic antibiotics administered at 2 academic medical centers during a 6-year period where a cephalosporin was indicated but an "allergy" to penicillin was noted. Another drug (typically vancomycin or clindamycin) was substituted approximately 80% of the time; this occurred frequently even when symptoms unrelated to acute hypersensitivity were listed. In >50% of cases, the reaction was either omitted or vague (e.g., simply "rash"). Given the estimated 1% cross-reactivity between penicillins and cephalosporins with similar R1 side chains, many of these patients could have received either the prescribed cephalosporin or another cephalosporin with a different R1 side chain...
May 1, 2016: A & A Case Reports
Dennis K Ledford
No abstract text is available yet for this article.
November 2015: Journal of Allergy and Clinical Immunology in Practice
E Dias de Castro, A Leblanc, A Sarmento, J R Cernadas
Recent studies have demonstrated a low cross-reactivity between β-lactam antibiotics and carbapenems in IgE-mediated reactions. There are no studies on cross-reactivity of meropenem in patients with non-immediate hypersensitivity to cephalosporins. We describe a case of a 13-year-old male, admitted in Neurosurgery with a severe extradural empyema complicating frontal sinusitis, submitted to an emergent bifrontal craniotomy. A generalized maculopapular exanthema, fever and malaise, appeared by the 7th day of meningeal doses of ceftriaxone, clindamycin and vancomycin...
November 2015: European Annals of Allergy and Clinical Immunology
Natalia V Beloglazova, Sergei A Eremin
In this paper we describe the development of a sensitive, fast, and easily performed fluorescence polarization immunoassay for determination of cephalexin in milk. The experimental work was performed to increase sensitivity and specificity. Therefore, the structures of the tracers were varied by synthesis of both cephalexin (CEX) and cephalotin (CET) conjugates with a variety of fluorescent labels. Two rabbit antisera containing antibodies against cephalexin and cephalotin were tested in homologous and heterologous combinations with the tracers...
November 2015: Analytical and Bioanalytical Chemistry
J A Martinez Tadeo, E Perez Rodriguez, Z Almeida Sanchez, A Callero Viera, J C Garcia Robaina
No abstract text is available yet for this article.
2015: Journal of Investigational Allergology & Clinical Immunology
Antonino Romano, Francesco Gaeta, Rocco Luigi Valluzzi, Michela Maggioletti, Alessandra Zaffiro, Cristiano Caruso, Donato Quaratino
BACKGROUND: Studies regarding the cross-reactivity and tolerability of alternative cephalosporins in large samples of subjects with an IgE-mediated hypersensitivity to cephalosporins are lacking. OBJECTIVE: We sought to evaluate the possibility of using alternative cephalosporins in subjects with cephalosporin allergy who especially require them. METHODS: One hundred two subjects with immediate reactions to cephalosporins and positive skin test results to the responsible drugs underwent serum specific IgE assays with cefaclor and skin tests with different cephalosporins...
September 2015: Journal of Allergy and Clinical Immunology
Ralph J Beltran, Hiromi Kako, Thomas Chovanec, Archana Ramesh, Bruno Bissonnette, Joseph D Tobias
BACKGROUND: First generation cephalosporins are commonly used as antibiotic prophylaxis prior to surgery. Patients labeled as penicillin-allergic are often precluded from receiving cephalosporins because of an allergic cross-reactivity. The aims of this study were to evaluate the clinical practice for surgical prophylaxis at Nationwide Children's Hospital and to determine the incidence of adverse effects and allergic reactions when using cephalosporins in patients labeled as penicillin-allergic...
May 2015: Journal of Pediatric Surgery
Michael J Persky, Scott A Roof, Yixin Fang, Daniel Jethanamest, Max M April
OBJECTIVES/HYPOTHESIS: This study investigated the differences between the standard guidelines and the practice patterns of otolaryngologists in managing "penicillin-allergic" patients. A major goal was to identify factors influencing an otolaryngologist's choice of antibiotic. STUDY DESIGN: Cross-sectional survey. METHODS: Four hundred seventy members of the American Society of Pediatric Otolaryngologists (ASPO) and 150 general otolaryngologists from the Florida Society of Otolaryngology (FSO) were surveyed...
August 2015: Laryngoscope
Thomas Tängden, Mia Furebring, Elisabeth Löwdin, Sonja Werner
Severe IgE-mediated allergic reactions to penicillins are rare but might be fatal. Because some studies demonstrated a high risk of cross-sensitivity to cephalosporins and carbapenems it has been recommended to avoid these antibiotics in patients with suspected hypersensitivity to penicillins. However, recent studies and analyses conclude that the risk of cross-reactivity was overestimated in the earlier studies and that it is in fact very low for parenteral cephalosporins and perhaps even negligible for carbapenems...
2015: Läkartidningen
R Mirakian, S C Leech, M T Krishna, A G Richter, P A J Huber, S Farooque, N Khan, M Pirmohamed, A T Clark, S M Nasser
The Standards of Care Committee of the British Society for Allergy and Clinical Immunology (BSACI) and an expert panel have prepared this guidance for the management of immediate and non-immediate allergic reactions to penicillins and other beta-lactams. The guideline is intended for UK specialists in both adult and paediatric allergy and for other clinicians practising allergy in secondary and tertiary care. The recommendations are evidence based, but where evidence is lacking, the panel reached consensus...
February 2015: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
A Buonomo, E Nucera, V Pecora, A Rizzi, A Aruanno, L Pascolini, A G Ricci, A Colagiovanni, D Schiavino
BACKGROUND AND OBJECTIVE: 13-Lactams are the most commonly used antibiotics but they can cause hypersensitivity reactions. We sought to estimate cross-reactivity and tolerability of cephalosporins in patients with cell-mediated allergy to penicillins. METHODS: We studied 97 patients with a clinical history of nonimmediate reactions to a penicillin and a positive patch test result to at least 1 of the penicillins tested. All patients also underwent patch testing with several cephalosporins...
2014: Journal of Investigational Allergology & Clinical Immunology
Q U Lee
A 10% cross-reactivity rate is commonly cited between penicillins and cephalosporins. However, this figure originated from studies in the 1960s and 1970s which included first-generation cephalosporins with similar side-chains to penicillins. Cephalosporins were frequently contaminated by trace amount of penicillins at that time. The side-chain hypothesis for beta-lactam hypersensitivity is supported by abundant scientific evidence. Newer generations of cephalosporins possess side-chains that are dissimilar to those of penicillins, leading to low cross-reactivity...
October 2014: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Eric Macy
Penicillin is the most common beta-lactam antibiotic allergy and the most common drug class allergy, reported in about 8% of individuals using health care in the USA. Only about 1% of individuals using health care in the USA have a cephalosporin allergy noted in their medical record, and other specific non-penicillin, non-cephalosporin beta-lactam allergies are even rarer. Most reported penicillin allergy is not associated with clinically significant IgE-mediated reactions after penicillin rechallenge. Un-verified penicillin allergy is a significant and growing public health problem...
November 2014: Current Allergy and Asthma Reports
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