Prescott William A, Kusmierski Kristen A
Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, New York 14260-1200, USA.
Pharmacotherapy. 2007 Jan;27(1):137-42. doi: 10.1592/phco.27.1.137.
The risk of carbapenem hypersensitivity in patients with self-reported or documented penicillin allergy needs to be determined so that practitioners can make better-informed decisions regarding antibiotic therapy for this patient population. The risk of cross-reactivity between penicillin and carbapenem antibiotics initially was reported to approach 50%. Recent retrospective studies have suggested that the clinical risk of cross-hypersensitivity between these two drug classes is 9.2-11%, which is significantly lower than initially reported. Patients whose history of penicillin allergy is self-reported and is not type 1 may be at moderate risk for hypersensitivity when treated with a carbapenem antibiotic. The risk of hypersensitivity appears to be higher in patients whose penicillin allergy was documented by a health care provider, those with several antibiotic allergies, and those with a positive penicillin skin test result or a history of type 1 penicillin hypersensitivity.
需要确定自述或有记录表明对青霉素过敏的患者发生碳青霉烯类超敏反应的风险，以便从业者能够就该患者群体的抗生素治疗做出更明智的决策。最初报道青霉素与碳青霉烯类抗生素之间的交叉反应风险接近50%。最近的回顾性研究表明，这两类药物之间交叉超敏反应的临床风险为9.2%-11%，明显低于最初报道的风险。自述对青霉素过敏且非1型过敏的患者在使用碳青霉烯类抗生素治疗时可能有中度超敏反应风险。在有医疗服务提供者记录的青霉素过敏患者、有多种抗生素过敏的患者以及青霉素皮肤试验结果呈阳性或有1型青霉素超敏反应病史的患者中，超敏反应风险似乎更高。
