Beta-Lactam Allergy and Cross-Reactivity.
10.3904/kjm.2014.87.6.652
- Author:
Sang Hoon KIM
1
Author Information
1. Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea. ksh1134@eulji.ac.kr
- Publication Type:In Vitro ; Review
- Keywords:
Allergy;
Hypersensitivity;
Diagnosis;
Penicillin;
Cephalosporin
- MeSH:
Anti-Bacterial Agents;
Cephalosporins;
Diagnosis;
Drug Hypersensitivity;
Humans;
Hypersensitivity*;
Korea;
Mass Screening;
Penicillins;
Skin Tests
- From:Korean Journal of Medicine
2014;87(6):652-658
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Penicillins and cephalosporins are commonly prescribed beta-lactam antibiotics that are able to induce severe and sometimes even life-threatening hypersensitivity reactions. These reactions can be broadly classified as immediate or non-immediate/delayed depending on the onset of the reaction after the last drug administration. A definitive diagnosis of beta-lactam hypersensitivity is required to carry out the proper preventive measures. The diagnostic approach to beta-lactam allergy should be considered if the risk/possible benefit ratio is positive. In Korea, however, the diagnostic approach to beta-lactam allergy remains a major challenge. Major and minor determinants of penicillin for skin testing are unavailable, making skin testing appear to be less sensitive. Drug allergy work-ups that include standardized skin tests, reliable in vitro tests, and drug provocation tests are rarely carried out in clinical practice. However, screening patients without a prior history of beta-lactam allergy is routinely recommended. In this review, we discuss practical evaluation of beta-lactam allergy and cross-reactivity between penicillins and cephalosporins.
