Cross-reactivity with carbapenems is very unlikely (Cefazolin is an option as it has a dissimilar R1 side chain to penicillins and cephalosporins.19.Non-IgE-mediated hypersensitivity reactions (maculopapular rash, acute interstitial nephritis, immune-mediated hepatitis) have been reported with anti-staphylococcal penicillins (e.g.
#Cross reactivity allergy chart skin#
The rate of cross-reactivity between a penicillin and cephalosporin due to antibody recognition is The cross-reactivity between B-lactams with IgE-mediated hypersensitivity may be predicted by similarities of R-side chains.The Northwesten Medicine Antimicrobial Stewardship Program created a B-lactam allergy side chain chart (pictured above) as well as a clinical pathway for assessing B-lactam allergy risk, to assist medical providers in determining appropriate cephalosporin therapy in patients with penicillin allergy. Correctly identifying those who are not truly penicillin-allergic can decrease unnecessary use of broad-spectrum antibiotics.The use of broad-spectrum antibiotics in patients labeled “penicillin-allergic” is associated with higher healthcare costs, increased risk for antibiotic resistance, and suboptimal antibiotic therapy. Broad-spectrum antibiotics are often used as an alternative to penicillins.Approximately 80% of patients with IgE-mediated penicillin allergy lose their sensitivity after 10 years.When evaluated, fewer than1% of the population are truly allergic to penicillins. However, many patients who report penicillin allergies do not have true IgE-mediated reactions.patients report having an allergic reaction to a penicillin class antibiotic in their past. Reproduced with permission from the Northwestern Medicine Antimicrobial Stewardship Program
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