DRESS caused by suspected cross-allergy between cephalosporins and carbapenems：a case report
- VernacularTitle:1例疑似头孢菌素类与碳青霉烯类交叉过敏致DRESS病例报道
- Author:
Lu HE
1
;
Yan QIAN
1
Author Information
1. Dept. of Pharmacy，the Second Affiliated Hospital of Chongqing Medical University，Chongqing 400010，China
- Publication Type:Journal Article
- Keywords:
drug reactions with eosinophilia and systemic symptoms;
drug hypersensitivity syndrome;
eosinophilia;
β-lactams
- From:
China Pharmacy
2025;36(15):1915-1920
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the pathogenesis， diagnosis and treatment of drug reaction with eosinophilia and systemic symptoms （DRESS） caused by cross-allergy between cephalosporins and carbapenems， and provide reference for safe clinical medication. METHODS Clinical pharmacists participated in the diagnosis and treatment process of a patient with severe pneumonia whose DRESS caused by suspected cross-allergy between cephalosporins and carbapenems in our hospital. At the same time， relevant studies on the pathogenesis， diagnosis， treatment， and cross-allergy between cephalosporins and carbapenems were retrieved for analysis. Based on the clinical manifestations and treatment process of this patient， the possible mechanisms of cross- allergy between cephalosporins and carbapenems and the treatment strategies for DRESS were discussed. RESULTS The RegiSCAR score of this patient was 6 points， confirming the diagnosis of DRESS. There may be β-lactam ring-specific human leucocyte antigen alleles or T-cell receptors， which led to suspected cross-allergic reactions between cephalosporins and carbapenems. The clinical pharmacists suggested discontinuing cephalosporins and carbapenems and using methylprednisolone combined with immunoglobulin for treatment. The physician adopted the pharmacist’s suggestion， and the patient did not have fever again and the rash gradually subsided. CONCLUSIONS There is a possibility of cross-allergy between cephalosporins and carbapenems causing DRESS. For patients with DRESS， it is recommended to promptly investigate the suspected drugs and discontinue them. The combination of glucocorticoids and immunoglobulin is a feasible treatment option. Medical institutions with conditions should conduct herpesvirus screening and treatment.
