Korean J Med.  2014 Dec;87(6):652-658. 10.3904/kjm.2014.87.6.652.

Beta-Lactam Allergy and Cross-Reactivity

• Kim SH

• KMID: 2269359
• DOI: http://doi.org/10.3904/kjm.2014.87.6.652

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.

Keyword

Allergy; Hypersensitivity; Diagnosis; Penicillin; Cephalosporin

MeSH Terms

Anti-Bacterial Agents
Cephalosporins
Diagnosis
Drug Hypersensitivity
Humans
Hypersensitivity*
Korea
Mass Screening
Penicillins
Skin Tests
Anti-Bacterial Agents
Cephalosporins
Penicillins