Blanca M, Fernandez J, Miranda A, Terrados S, Torres M J, Vega J M, Avila M J, Perez E, Garcia J J, Suau R
Allergy Section, Carlos Haya Hospital, Malaga, Spain.
J Allergy Clin Immunol. 1989 Feb;83(2 Pt 1):381-5. doi: 10.1016/0091-6749(89)90122-x.
Nineteen well-characterized penicillin-allergic patients were investigated for their sensitivity to cephalosporins containing potentially cross-reactive side chains. All patients were administered cephamandole parenterally and, if this was tolerated, a course of oral cephaloridine was administered. Only two patients responded to the cephamandole; none of the remaining patients reacted to cephaloridine. Benzylpenicilloyl RAST-inhibition studies with sera from three subjects who had not reacted to the cephalosporins demonstrated that cephamandole linked to proteins was capable of recognizing benzylpenicilloyl-specific IgE antibody. It is concluded that consideration of side chain structures can help to predict possible cross-reactions between penicillins and cephalosporins, but carefully controlled challenge tests are advisable before penicillin-allergic patients are treated with cephalosporins. In relation to cross-reacting potential, in vitro experimental studies are difficult to interpret and may in some circumstances overestimate the risk.
