Cephalosporin Allergy: Current Understanding and Future Challenges

David A Khan, Aleena Banerji, Jonathan A. Bernstein, Basar Bilgicer, Kimberly Blumenthal, Mariana Castells, Daniel Ein, David M. Lang, Elizabeth Phillips

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Cephalosporins are commonly used antibiotics both in hospitalized patients and in outpatients. Hypersensitivity reactions to cephalosporins are becoming increasingly common with a wide range of immunopathologic mechanisms. Cephalosporins are one of the leading causes for perioperative anaphylaxis and severe cutaneous adverse reactions. Patients allergic to cephalosporins tend to tolerate cephalosporins with disparate R1 side chains but may react to other beta-lactams with common R1 side chains. Skin testing for cephalosporins has not been well validated but appears to have a good negative predictive value for cephalosporins with disparate R1 side chains. In vitro tests including basophil activation tests have lower sensitivity when compared with skin testing. Rapid drug desensitization procedures are safe and effective and have been used successfully for immediate and some nonimmediate cephalosporin reactions. Many gaps in knowledge still exist regarding cephalosporin hypersensitivity.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology: In Practice
DOIs
StatePublished - Jan 1 2019

Fingerprint

Cephalosporins
Hypersensitivity
Skin
Basophils
beta-Lactams
Anaphylaxis
Outpatients
Anti-Bacterial Agents
Pharmaceutical Preparations

Keywords

  • Allergy
  • Anaphylaxis
  • Beta-lactam
  • Cephalosporin
  • Cross-reactivity
  • Penicillin
  • Skin test

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Cephalosporin Allergy : Current Understanding and Future Challenges. / Khan, David A; Banerji, Aleena; Bernstein, Jonathan A.; Bilgicer, Basar; Blumenthal, Kimberly; Castells, Mariana; Ein, Daniel; Lang, David M.; Phillips, Elizabeth.

In: Journal of Allergy and Clinical Immunology: In Practice, 01.01.2019.

Research output: Contribution to journalArticle

Khan, David A ; Banerji, Aleena ; Bernstein, Jonathan A. ; Bilgicer, Basar ; Blumenthal, Kimberly ; Castells, Mariana ; Ein, Daniel ; Lang, David M. ; Phillips, Elizabeth. / Cephalosporin Allergy : Current Understanding and Future Challenges. In: Journal of Allergy and Clinical Immunology: In Practice. 2019.
@article{1d50de0324e94a59a5fe9a64893bc0b9,
title = "Cephalosporin Allergy: Current Understanding and Future Challenges",
abstract = "Cephalosporins are commonly used antibiotics both in hospitalized patients and in outpatients. Hypersensitivity reactions to cephalosporins are becoming increasingly common with a wide range of immunopathologic mechanisms. Cephalosporins are one of the leading causes for perioperative anaphylaxis and severe cutaneous adverse reactions. Patients allergic to cephalosporins tend to tolerate cephalosporins with disparate R1 side chains but may react to other beta-lactams with common R1 side chains. Skin testing for cephalosporins has not been well validated but appears to have a good negative predictive value for cephalosporins with disparate R1 side chains. In vitro tests including basophil activation tests have lower sensitivity when compared with skin testing. Rapid drug desensitization procedures are safe and effective and have been used successfully for immediate and some nonimmediate cephalosporin reactions. Many gaps in knowledge still exist regarding cephalosporin hypersensitivity.",
keywords = "Allergy, Anaphylaxis, Beta-lactam, Cephalosporin, Cross-reactivity, Penicillin, Skin test",
author = "Khan, {David A} and Aleena Banerji and Bernstein, {Jonathan A.} and Basar Bilgicer and Kimberly Blumenthal and Mariana Castells and Daniel Ein and Lang, {David M.} and Elizabeth Phillips",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jaip.2019.06.001",
language = "English (US)",
journal = "Journal of Allergy and Clinical Immunology: In Practice",
issn = "2213-2198",
publisher = "Elsevier",

}

TY - JOUR

T1 - Cephalosporin Allergy

T2 - Current Understanding and Future Challenges

AU - Khan, David A

AU - Banerji, Aleena

AU - Bernstein, Jonathan A.

AU - Bilgicer, Basar

AU - Blumenthal, Kimberly

AU - Castells, Mariana

AU - Ein, Daniel

AU - Lang, David M.

AU - Phillips, Elizabeth

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Cephalosporins are commonly used antibiotics both in hospitalized patients and in outpatients. Hypersensitivity reactions to cephalosporins are becoming increasingly common with a wide range of immunopathologic mechanisms. Cephalosporins are one of the leading causes for perioperative anaphylaxis and severe cutaneous adverse reactions. Patients allergic to cephalosporins tend to tolerate cephalosporins with disparate R1 side chains but may react to other beta-lactams with common R1 side chains. Skin testing for cephalosporins has not been well validated but appears to have a good negative predictive value for cephalosporins with disparate R1 side chains. In vitro tests including basophil activation tests have lower sensitivity when compared with skin testing. Rapid drug desensitization procedures are safe and effective and have been used successfully for immediate and some nonimmediate cephalosporin reactions. Many gaps in knowledge still exist regarding cephalosporin hypersensitivity.

AB - Cephalosporins are commonly used antibiotics both in hospitalized patients and in outpatients. Hypersensitivity reactions to cephalosporins are becoming increasingly common with a wide range of immunopathologic mechanisms. Cephalosporins are one of the leading causes for perioperative anaphylaxis and severe cutaneous adverse reactions. Patients allergic to cephalosporins tend to tolerate cephalosporins with disparate R1 side chains but may react to other beta-lactams with common R1 side chains. Skin testing for cephalosporins has not been well validated but appears to have a good negative predictive value for cephalosporins with disparate R1 side chains. In vitro tests including basophil activation tests have lower sensitivity when compared with skin testing. Rapid drug desensitization procedures are safe and effective and have been used successfully for immediate and some nonimmediate cephalosporin reactions. Many gaps in knowledge still exist regarding cephalosporin hypersensitivity.

KW - Allergy

KW - Anaphylaxis

KW - Beta-lactam

KW - Cephalosporin

KW - Cross-reactivity

KW - Penicillin

KW - Skin test

UR - http://www.scopus.com/inward/record.url?scp=85068785769&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068785769&partnerID=8YFLogxK

U2 - 10.1016/j.jaip.2019.06.001

DO - 10.1016/j.jaip.2019.06.001

M3 - Article

C2 - 31495420

AN - SCOPUS:85068785769

JO - Journal of Allergy and Clinical Immunology: In Practice

JF - Journal of Allergy and Clinical Immunology: In Practice

SN - 2213-2198

ER -