Abstract
The objective was to review the frequency of allergic cross-reactivity between penicillins and cephalosporin antibiotics. MEDLINE and EMBASE databases were searched for all English language articles relevant to penicillin and cephalosporin cross-sensitivity. Among 219 retrieved articles, 103 were included in the review. Based on 38 studies, the evidence suggests that the crossreactive, immunoglobulin E (IgE)-mediated immune responses between penicillins and cephalosporins are based on molecular side chain similarities of the antibiotics rather than similarities in β lactam rings. Twenty-eight studies examined 5420 patients with a history of penicillin allergy compared to 47,976 without such a history who received cephalosporins; possible allergic reactions were noted in 138 (2.55%) and 654 (1.36%) patients respectively (p < 0.0001). However, the risk of a cross-allergic reaction occurred predominantly among patients receiving first-generation cephalosporins with related chemical side chains to penicillin ...
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