PMID- 21329623
OWN - NLM
STAT- MEDLINE
DCOM- 20110512
LR  - 20190608
IS  - 0946-1965 (Print)
IS  - 0946-1965 (Linking)
VI  - 49
IP  - 3
DP  - 2011 Mar
TI  - Cephalosporin and penicillin cross-reactivity in patients allergic to 
      penicillins.
PG  - 206-16
AB  - BACKGROUND: Bata-lactam antibiotics are the most commonly used antibiotics which 
      usually cause serious IgE-mediated allergic reactions. Of all bata-lactam 
      antibiotics, penicillins have so far been the best-studied, but the studies of 
      cephalosporins and their cross-reactivity with penicillins are rare. We sought to 
      evaluate the IgE response in vitro and estimate cross-reactivity between 
      penicillins and cephalosporins in patients allergic to penicillins. METHODS: We 
      studied 87 control subjects and 420 subjects allergic to penicillins. 
      Radioallergosorbent test (RAST) was performed to detect eight types of 
      specific-penicillin IgE and eleven types of specific-cephalosporin IgE. The 
      cross-reactivity and different molecules recognition by IgE were studied with a 
      radioallergosorbent inhibition test. RESULTS: Of 420 patients allergic to 
      penicillins, 95 patients (22.62%) showed specific-cephalosporin IgE positive, 73 
      patients (17.38%) showed IgEs positive to both penicillins and cephalosporins. In 
      specific-penicillin IgE positive group, the positive rate of 
      specific-cephalosporin IgE was significantly higher than in specific-penicillin 
      IgE negative group (27.14% vs. 14.57%, p < 0.01). In urticaria group, the 
      positive rate of specific-cephalosporin IgE was significantly higher than in 
      other symptoms group (30.65% vs. 8.11%, p < 0.05). The analysis of drugs which 
      have the same or similar side-chains showed that benzylpenicillanyl-IgE 
      (BPA-IgE), ampicillanyl-IgE (APA-IgE), amoxicillanyl-IgE (AXA-IgE) were 
      respectively related to cephalothanyl-IgE (CLA-IgE), cephalexanyl-IgE (CEXA-IgE), 
      cephalexanyl-IgE (CEXA-IgE)in sera of penicillin-allergic patients we studied, 
      and compared with patients who had negative amoxicillin-IgE, the positive rates 
      of specific-ampicillin IgE and specific-cephalexin IgE were significantly higher 
      in patients who had positive amoxicillin-IgE (14.43% vs. 3.72%, 14.00% vs. 2.96%, 
      p < 0.01). Radioallergosorbent test and radioallergosorbent inhibition test 
      confirmed that both nuclear structure and R1 side-chain contribute to IgE 
      recognition. CONCLUSIONS: There exists cross-reactivity between cephalosporins 
      and penicillins; patients allergic to several penicillins are more likely to 
      develop allergic reaction to cephalosporins; due to sensitization to the similar 
      structural characteristics (nuclear and R1 side-chain), penicillin-allergic 
      patients may develop cross-allergic reactions with not only first-generation but 
      also third-generation cephalosporins.
FAU - Liu, X-D
AU  - Liu XD
AD  - Department of Clinical Pharmacology, School of Medicine, Zhengzhou University, 
      Zhengzhou, China.
FAU - Gao, N
AU  - Gao N
FAU - Qiao, H-L
AU  - Qiao HL
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Int J Clin Pharmacol Ther
JT  - International journal of clinical pharmacology and therapeutics
JID - 9423309
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Cephalosporins)
RN  - 0 (Penicillins)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Anti-Bacterial Agents/*adverse effects/chemistry/immunology
MH  - Cephalosporins/*adverse effects/chemistry/immunology
MH  - Cross Reactions/immunology
MH  - Drug Hypersensitivity/*immunology
MH  - Female
MH  - Humans
MH  - Immunoglobulin E/immunology
MH  - Male
MH  - Middle Aged
MH  - Penicillins/*adverse effects/chemistry/immunology
MH  - Radioallergosorbent Test
MH  - Urticaria/chemically induced
MH  - Young Adult
EDAT- 2011/02/19 06:00
MHDA- 2011/05/13 06:00
CRDT- 2011/02/19 06:00
PHST- 2011/02/19 06:00 [entrez]
PHST- 2011/02/19 06:00 [pubmed]
PHST- 2011/05/13 06:00 [medline]
AID - 8435 [pii]
AID - 10.5414/cpp49206 [doi]
PST - ppublish
SO  - Int J Clin Pharmacol Ther. 2011 Mar;49(3):206-16. doi: 10.5414/cpp49206.