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- Title
A statement on cefazolin immediate hypersensitivity: data from a large database, and focus on the cross-reactivities.
- Authors
Pipet, A.; Veyrac, G.; Wessel, F.; Jolliet, P.; Magnan, A.; Demoly, P.; Bousquet, P. J.
- Abstract
Summary Background More perioperative cefazolin use has resulted in an increased risk of cefazolin-associated reactions. Objective The aim of this article is to study immediate reactions to cefazolin and attempt to determine possible allergic cross-reactivity with other ß-lactams using data from the Drug Allergy and Hypersensitivity Database ( DAHD). Methods All 25 cefazolin-associated reactions in the DAHD were reviewed. The cases identified were then investigated according to the European Network for Drug Allergy ( ENDA) recommendations by skin testing and challenges. Results A total of 10 individuals with proven IgE-mediated cefazolin hypersensitivity were identified between January 1999 and July 2009. All the index reactions were compatible with an acute IgE-mediated process, six with anaphylaxis, two with systemic allergic reactions without hypotension, and two with urticaria/angioedema. Cefazolin skin tests were positive in seven individuals and cefazolin challenges were positive in three more individuals. In the eight cefazolin allergic patients who had challenges with other ß-lactams, there was no positive reaction noted. Conclusion and Clinical Relevance In this cohort of patients with IgE-mediated reactions to cefazolin, a majority tolerated amoxicillin and several patients tolerated other cephalosporins. This implies that the R1 side-chain may play an essential role in IgE-mediated reactions to cefazolin. No clear rule to predict cross-reactivity with other ß-lactams could be determined. More research on IgE-mediated hypersensitivity to cefazolin and other cephalosporins is needed.
- Subjects
CEFAZOLIN; ALLERGIES; HYPOTENSION; ANGIONEUROTIC edema; AMOXICILLIN; CEPHALOSPORINS; PENICILLIN
- Publication
Clinical & Experimental Allergy, 2011, Vol 41, Issue 11, p1602
- ISSN
0954-7894
- Publication type
Article
- DOI
10.1111/j.1365-2222.2011.03846.x