![]() Even penicillin skin testing is generally not predictive of cephalosporin allergy. (2) The presence of these antibodies does not predict allergic, IgE cross-sensitivity to a cephalosporin. Most people produce IgG and IgM antibodies in response to exposure to penicillin (1) that may cross-react with cephalosporin antigens. What is certain is that a blanket dismissal of all cephalosporins is unfounded.ĭespite myriad studies spanning decades and involving varied patient populations, results have not conclusively established that penicillin allergy increases the risk of an allergic reaction to cephalosporins, compared with the incidence of a primary (and unrelated) cephalosporin allergy. ![]() ![]() But even for patients truly allergic to penicillin, is the concern over cephalosporins justified? It depends on the specific agent. To be safe, we often label these patients as penicillin-allergic without further questioning and withhold not only penicillins but cephalosporins due to concerns about potential cross-reactivity and resultant IgE-mediated, type I reactions. Undoubtedly you have patients who say they are allergic to penicillin but have difficulty recalling details of the reactions they experienced. * Cefprozil, cefuroxime, cefpodoxime, ceftazidime, and ceftriaxone do not increase risk of an allergic reaction (B). * Cephalothin, cephalexin, cefadroxil, and cefazolin confer an increased risk of allergic reaction among patients with penicillin allergy (B). * The widely quoted cross-allergy risk of 10% between penicillin and cephalosporins is a myth (A). ![]()
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