Department of Pediatrics, University of Pavia, Italy.
Int J Immunopathol Pharmacol. 2011 Jul-Sep;24(3 Suppl):S47-53. doi: 10.1177/03946320110240s307.
Antibiotics are commonly injected during the perioperative period and are responsible of 15 percent of the anaphylactic reactions. Anaphylaxis triggered by antibiotics primarily involves penicillin and cephalosporin. The management of patients with histories of allergic reactions to antibiotics is a common situation in clinical practice. The confirmation or invalidation of the allergic nature of the reported reaction is not based on in vitro tests, but on a rigorous allergological work-up based on detailed analysis of clinical history, skin tests and drug provocation test. Considering a possible cross-reactivity between penicillins, once an immediate penicillin allergy has been diagnosed, skin testing with the alternative molecule (cephalosporin, carbapenem, aztreonam) is mandatory and, if negative, the relevant drug should be given in an appropriate setting at increasing doses.
抗生素在围手术期通常被注射，占过敏反应的 15%。抗生素引起的过敏反应主要涉及青霉素和头孢菌素。管理对抗生素有过敏反应病史的患者是临床实践中的常见情况。报告的过敏反应的过敏性质的确认或否定不是基于体外测试，而是基于基于详细的临床病史分析、皮肤测试和药物激发试验的严格过敏学检查。考虑到青霉素之间可能存在交叉反应，一旦诊断出即刻青霉素过敏，必须用替代分子（头孢菌素、碳青霉烯、氨曲南）进行皮试，如果皮试阴性，应在适当的环境下逐渐增加剂量给予相关药物。
