An allergy to sulfonamide medications is different from having an adverse reaction to wine or food that contains sulfites. The similarity in structure of the R1-side-chains of penicillins and cephalosporins determines the likelihood of cross-sensitivity between the drug classes - not the presence of the beta-lactam ring. • If a patient states they have a beta-lactam allergy, get a specific medication, reaction, and timing of reaction (immediate vs. delayed) DO NOT accept “penicillin” or “cephalosporin” as an allergy • Update allergy label with specific medications, reactions, and tolerances (i.e. Like most other drugs, cephalosporins are small molecules that are not independently capable of causing an allergic reaction.19, 20 An immune classification system provides a framework for mechanistically understanding the differing clinical phenotypes of cephalosporin reactions, and models have been proposed to explain how small molecules activate immune responses (Figure 2, Figure … This has been a safe and effective strategy for many drugs including cephalosporins. Some 1st-generation and Clin Exp Allergy. “tolerates ceftriaxone”) However, clinicians may avoid the use of cephalosporins in patients with reported penicillin allergies despite the low potential for cross-reactivity. 2005;35(9):1234-42. The misdiagnosis of -lactam allergies and misunderstanding of cross-reactivity among -lactams, including within Up to 10% of people with a history of penicillin allergy will also be allergic to cephalosporins. … a cephalosporin allergy. Diagnosing immediate reactions to cephalosporins. Cephalosporin antibiotics are widely prescribed for common infections such as bronchitis, otitis media, pneumonia, and cellulitis. Successive generations of cephalosporins have increased activity against Gram-negative bacteria, albeit often with reduced activity against Gram-positive organisms. This is because while research shows a low risk of reacting to a cephalosporin in people with a penicillin allergy, there is one exception—first-generation cephalosporins like cephalexin (Keflex) and cefazolin (Ancef) cause higher rates of allergic reactions in people with a penicillin allergy than people without a penicillin allergy. The allergic determinants of cephalosporins can be derived from the beta-lactam structure. Allergic reactions have been reported with cephalosporins (including first generation cephalosporins) and symptoms may include a rash, hives , swelling, or rarely, anaphylaxis. However, cross-reactivity between penicillins and cephalosporins, and between different cephalosporins, is mainly dependent on the R-group side chain structures of these antibiotics. The drug is … Romano A, Gueant-Rodriguez RM, Viola M, Amoghly F, Gaeta F, Nicolas JP, et al. Cephalosporin-allergic patients may have cross-reactivity with determinants of the penicillins, with different cephalosporins, or may react to just a single cephalosporin.
(2) References: 1. If you have HIV/AIDS, you may have an increased sensitivity to sulfonamide medications. Background for Cephalosporin Allergy Pathway 1. Having a reaction to sulfites in something you eat or drink doesn't mean you'll be allergic to sulfonamide medication. The antibiotic may be used for patients who are allergic to penicillin due to the different β-lactam antibiotic structure.
Cephalosporins penetrate the cerebrospinal fluid poorly unless the meninges are inflamed; cefotaxime and ceftriaxone are suitable cephalosporins for infections of the CNS (e.g meningitis).