The Use of Cephalosporin in Penicilin-allergic Patients:
A Literature Review
Campagna JD., Bond JD., Schabelman E., Hayes BD. J Emerg Med 2012; 42(5):612-20
CONCLUSIONS: "Although a myth persists that approximately 10% of patients with a history of penicillin allergy will have an allergic reaction if given a cephalosporin, the overall cross-reactivity rate is approximately 1% when using first-generation cephalosporins or cephalosporins with similar R1 side chains. However, a single study reported the prevalence of cross reactivity with cefadroxil as high as 27%. For penicillin-allergic patients, the use of third- or fourth-generation cephalosporins or cephalosporins with dissimilar side chains than the offending penicillin carries a negligible risk of cross allergy."
*
Cephalosporins can be prescribed safely for penicillin-allergic patients
*Michael E. Pichichero, MD
*University of Rochester Medical
Center,
Practice recommendations:
-The widely quoted cross-allergy risk of 10% between
penicillin and cephalosporins is a myth (A).
-Cephalothin, cephalexin, cefadroxil, and cefazolin
confer an increased risk of allergic reaction among patients with penicillin
allergy (B).
-Cefprozil, cefuroxime, cefpodoxime, ceftazidime,
and ceftriaxone do not increase risk of an allergic reaction
(B).