EBQ:Cephalosporin Cross-reactivity: Difference between revisions

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[[penicillins|Penicillins]] (PCN) and [[cephalosporins]] were produced with the same fungi during synthesis.  This increased the rate of cross contamination especially prior to 1980.  Although the allergy was though to be due to the similarities in the beta-lactam ring it is more probably caused due to manufacturing contamination although there is cross reactivity risk based on side chain similarity.  1st and 2nd generation [[penicillins]] share the same R-1 side chain.<ref>UIC Pharmacology on Penicillin Cross Reactivity https://www.uic.edu/pharmacy/services/di/crossens.htm</ref>  However, a current review of the literature demonstrates that the 10% or greater allergy may be exaggerated.<ref name="campagna">Campagna JD, Bond MC, Schabelman E, Hayes BD. The use of cephalosporins in penicillin-allergic patients: A literature review. J Emerg Med. 2012;42(5):612-20</ref>
==Background==
Previously, [[penicillins]] (PCN) and [[cephalosporins]] were produced with the same fungi during synthesis.  This increased the rate of cross contamination especially prior to 1980.  Although the allergy was though to be due to the similarities in the beta-lactam ring it is more probably caused due to manufacturing contamination although there is cross reactivity risk based on side chain similarity.  1st and 2nd generation [[penicillins]] share the same R-1 side chain.<ref>UIC Pharmacology on Penicillin Cross Reactivity https://www.uic.edu/pharmacy/services/di/crossens.htm</ref>  However, a current review of the literature demonstrates that the 10% or greater allergy may be exaggerated.<ref name="campagna">Campagna JD, Bond MC, Schabelman E, Hayes BD. The use of cephalosporins in penicillin-allergic patients: A literature review. J Emerg Med. 2012;42(5):612-20</ref>


* 1st generation [[cephalosporins]]: [[cefadroxil]], [[cefatrizine]], [[cephalexin]], cephradine
==Cross-Reaction Risk==
* 2nd generation c[[ephalosporins]]: [[cefaclor]], [[cefprozil]]
* Overall cross-reactivity rate between [[cephalosporins]] and [[penicillins]] in patients reporting a penicillin allergy = 1%.  <ref name="campagna"></ref>
* Overall cross-reactivity rate in patients with a confirmed penicillin allergy = 2.5%. <ref name="campagna"></ref>
* Cross-reactivity between [[penicillins]] and 1st and 2nd generation [[cephalosporins]] is possible.<ref name="campagna"></ref>
* Cross-reactivity between [[penicillins]] and ALL 3rd and 4th generation [[cephalosporins]] is negligible.<ref name="campagna"></ref>


== Campagna Review Article==
==Antibiotic Categories==
* Overall cross-reactivity rate between [[cephalosporins]] and [[penicillins]] in patients reporting a penicillin allergy = 1%.  <ref name="campagna"></ref>
{{Beta-lactams}}
* Overall cross-reactivity rate in patients with a confirmed penicillin allergy = 2.5%.
* Cross-reactivity between [[penicillins]] and 1st and 2nd generation [[cephalosporins]] is possible.
* Cross-reactivity between [[penicillins]] and ALL 3rd and 4th generation [[cephalosporins]] is negligible.


;If a patient has an allergy to [[amoxicillin]] or [[ampicillin]], avoid [[cefadroxil]], [[cefaclor]], [[cefatrizine]], [[cefprozil]], [[cephalexin]], and [[cephradine]].
==External Links==
*[https://umem.org/educational_pearls/2540/ UMEM - Penicillin Cephalosporin Cross-Reactivity Made Easy]


==See Also==
==See Also==
*[[Cephalosporins]]
*[[Cephalosporins]]


==Sources==
==References==
<references/>
<references/>


[[Category:EBQ]]
[[Category:EBQ]]
[[Category:Drugs]]
[[Category:Pharmacology]]

Latest revision as of 16:40, 26 March 2019

Background

Previously, penicillins (PCN) and cephalosporins were produced with the same fungi during synthesis. This increased the rate of cross contamination especially prior to 1980. Although the allergy was though to be due to the similarities in the beta-lactam ring it is more probably caused due to manufacturing contamination although there is cross reactivity risk based on side chain similarity. 1st and 2nd generation penicillins share the same R-1 side chain.[1] However, a current review of the literature demonstrates that the 10% or greater allergy may be exaggerated.[2]

Cross-Reaction Risk

Antibiotic Categories

External Links

See Also

References

  1. UIC Pharmacology on Penicillin Cross Reactivity https://www.uic.edu/pharmacy/services/di/crossens.htm
  2. 2.0 2.1 2.2 2.3 2.4 Campagna JD, Bond MC, Schabelman E, Hayes BD. The use of cephalosporins in penicillin-allergic patients: A literature review. J Emerg Med. 2012;42(5):612-20