Β-lactam allergy

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Β-lactam allergy /
Revision as of 14:08, 16 September 2020 by Aidan (talk | contribs) (Aidan moved page Beta-lactam allergies to β-lactam allergy without leaving a redirect)

Cross-reactivity

Antibiotic C7 C3
G1 G2 G3 G1 G2 G3 G4 G5 G6 G7
Penicillin X
Ampicillin X
Amoxicillin X
Cefazolin
Cephalexin X X
Cefadroxil X X
Cephalothin X X
Cefotetan X
Cefoxitin X X
Cefuroxime X
Cefaclor X
Cefotaxime X X
Ceftriaxone X
Ceftazidime X
Cefixime X
Cefdinir
Cefipime X
Ceftaroline

C-7 Side Chains

C-3 Side Chains

Hypersensitivity Reactions

  • Type I (IgE-mediated)
    • Anaphylaxis
    • Itchy rash
    • Penicillins should be avoided
  • Type II (IgG-mediated)
    • Non-itchy rash
    • Rash will improve if treatment continues, no need to avoid penicillins
  • Type IV (cell-mediated)
    • Toxic epidermal necrolysis
    • Stevens-Johnson syndrome
    • Penicillins should be avoided

Further Reading

  • Zagursky RJ and Pichichero ME. Cross-reactivity in β-Lactam Allergy. J Allergy Clin Immunol Pract. 2018;6(1):72-81.e1. doi: 10.1016/j.jaip.2017.08.027

References

  1. ^  Brittany Kula, Gordana Djordjevic, Joan L. Robinson. A Systematic Review: Can One Prescribe Carbapenems to Patients With IgE-Mediated Allergy to Penicillins or Cephalosporins?. Clinical Infectious Diseases. 2014;59(8):1113-1122. doi:10.1093/cid/ciu587.