Food and drug reactions and anaphylaxisImmediate allergic reactions to cephalosporins: Cross-reactivity and selective responses☆,☆☆
Section snippets
Patient selection
Subjects were selected from a large outpatient Italian population with a history of immediate reactions to injectable cephalosporins and positive results in allergologic evaluations performed between January 1995 and June 1998. We first evaluated the possible existence of allergy to penicillins by using skin tests and RASTs. Allergy to cephalosporin derivatives was evaluated by using skin tests to different cephalosporin compounds, including the culprit drug. In vitro–specific cephalosporin IgE
Results
A total of 30 patients (11 male and 19 female patients) were included in the study. The mean age was 40 years, ranging from 5 to 79 years. Our work-up was performed with a time interval of 12.36 ± 13.4 months (range, 1-48 months) after the most recent adverse reaction. Clinical data are shown in Table I. In all patients the time between drug administration and the onset of symptoms was less than 1 hour. The patients had a total of 25 episodes of anaphylactic shock and 11 episodes of urticaria
Discussion
Most studies of β-lactam allergy have been based on responses to penicillin or its derivatives.1, 2, 4 Furthermore, in studies of cross-reactivity between penicillins and cephalosporins, the subjects were originally sensitized to penicillins and cross-reactivity with cephalosporins was assessed by testing one or two compounds of the latter.1, 14, 15, 16, 17, 18 Few studies have been carried out to evaluate cross-reactivity with penicillin or other β-lactams in subjects with primary
Acknowledgements
We thank Ian Johnstone for his help with the English language version.
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Supported by FIS grant No. 00/0838.
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Reprint requests: Antonino Romano, MD, Unità di Allergologia, Complesso Integrato Columbus, Via G. Moscati, 31, 00168 Rome, Italy.