Infect Chemother.  2010 Jun;42(3):137-142. 10.3947/ic.2010.42.3.137.

IgE-Mediated Hypersensitivity Reactions to Cephalosporins

• Kim BN
• Cho YS

• KMID: 2170300
• DOI: http://doi.org/10.3947/ic.2010.42.3.137

Abstract

Cephalosporins are commonly prescribed either orally or parenterally for the treatment of bacterial infections because of wide safety margin compared with penicillins. Skin testing with a parent cephalosporin antibiotic has routinely been performed in Korea in the fear of developing anaphylaxis after the administration of a cephalosporin although penicillins are antibiotics that most commonly induce severe or life-threatening IgE-mediated reactions (anaphylaxis). In this review, we will discuss IgE-mediated hypersensitivity reactions to cephalosporins. Immunopathogenesis of IgE-mediated hypersensitivity reaction to cephalosporins, limitations of skin testing with parent cephalosporin antibiotics, and prescription strategy of cephalosporins for patients with a history of cephalosporin or penicillin hypersensitivity was described.

Keyword

Cephalosporins; Penicillins; Hypersensitivity; Anaphylaxis

MeSH Terms

Anaphylaxis
Anti-Bacterial Agents
Bacterial Infections
Cephalosporins
Humans
Hypersensitivity
Hypersensitivity, Immediate
Korea
Parents
Penicillins
Prescriptions
Skin Tests
Anti-Bacterial Agents
Cephalosporins
Penicillins

Figure

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  Figure 1 Structures of b-lactam antibiotics.

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  Figure 2 Matrix of penicillin and cephalosporin drugs with similar side-chain structures. 3, similarity at the cephalosporin 3-position side chain; 7, similarity at the cephalosporin 7-position side chain; 6/7, similarity at the penicillin 6-position side chain and the cephalosporin 7-position side chain. Drugs with 3-position or 7-position side chains dissimilar than any other include cefazolin, cefonicid, cefotiam, and moxalactam (13).

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