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

IgE-Mediated Hypersensitivity Reactions to Cephalosporins

  • 1Department of Internal Medicine, Inje University Sanggye-Paik Hospital, Inje Uni versity College of Medicine, Seoul, Korea.
  • 2Division of Allergy and Clinical Immunology, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.


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.


Cephalosporins; Penicillins; Hypersensitivity; Anaphylaxis

MeSH Terms

Anti-Bacterial Agents
Bacterial Infections
Hypersensitivity, Immediate
Skin Tests
Anti-Bacterial Agents


  • Figure 1 Structures of b-lactam antibiotics.

  • 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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