Tolerability of Cefazolin and Ceftibuten in Patients with IgE-Mediated Aminopenicillin Allergy
| Autor: | Donato Quaratino, Cristiano Caruso, Alessandra Zaffiro, Antonino Romano, Rocco Luigi Valluzzi, Francesco Gaeta |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Cephalosporin Cefazolin Aztreonam Penicillins Cross Reactions Drug Hypersensitivity 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Aminopenicillin Internal medicine polycyclic compounds medicine Immunology and Allergy Humans Ceftibuten 030212 general & internal medicine Prospective Studies Skin Tests business.industry biochemical phenomena metabolism and nutrition Immunoglobulin E bacterial infections and mycoses medicine.disease Anti-Bacterial Agents Cephalosporins Penicillin 030228 respiratory system Tolerability chemistry business Anaphylaxis medicine.drug |
| Zdroj: | The journal of allergy and clinical immunology. In practice. 8(6) |
| ISSN: | 2213-2201 |
| Popis: | Background Side-chain similarities or identities constitute the predominant factor for cross-reactivity between penicillins and cephalosporins, whereas differences in the side-chain structure seem to account for the absence of such cross-reactivity. Objective We sought to assess the cross-reactivity between penicillins and 2 cephalosporins (ie, cefazolin and ceftibuten) that have side chains different from those of penicillins, as well as to evaluate the possibility of using these cephalosporins in penicillin-allergic subjects. Methods We conducted a prospective study of 131 consecutive subjects who had suffered 170 immediate reactions (mostly anaphylaxis) to penicillins and had positive skin test results to at least 1 penicillin reagent. All patients underwent skin tests with cefazolin and ceftibuten. Patients with negative results were challenged with them. Results One participant had positive skin test results to cefazolin and ceftibuten, as well as to all other reagents tested, including aztreonam and carbapenems. All 129 subjects who underwent challenges with cefazolin and ceftibuten tolerated them. One subject refused cephalosporin challenges. Conclusions Subjects with an IgE-mediated hypersensitivity to penicillins could be treated with cephalosporins such as cefazolin and ceftibuten, which are among the cephalosporins that have side-chain determinants different from those of penicillins. Nevertheless, in patients with such hypersensitivity who need these alternative β-lactams, pretreatment skin tests are advisable because of the possibility of coexisting sensitivities or, much less frequently, of a sensitivity to an antigenic determinant of the common β-lactam ring. |
| Databáze: | OpenAIRE |
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