Ortega-Cisneros Margarita, Moras-Villela Victoria Leilani, Delgado-Bañuelos Angélica, Madrigal-Beas Ileana María, Aguilar-Chávez Yoal, Ochoa-García Itzel Vianey, Chávez-Meléndez Miguel Ángel, Gómez-Hernández Noemí
Instituto Mexicano del Seguro Social, Centro Médico Nacional de Occidente, Hospital de Especialidades, Jalisco, México.
Rev Alerg Mex. 2022;69 Suppl 1:s81-s93. doi: 10.29262/ram.v69iSup1.1038.
Betalactams are the most widely used antimicrobials for their safety and efficacy. These include the penicillins, cephalosporins, carbapenems, and monobactams. Penicillin allergy ranks first in relation to drug allergy. 10 to 20 % of the population is labeled as allergic to it, often wrongly. Cross reaction is reported in 2 to 5 % between penicillins and cephalosporin. There is no cross reaction between penicillins and aztreonam, but there is with ceftazidime. All the mechanisms of the Gell and Coombs classification are included in the pathophysiology of hypersensitivity reactions to penicillin. Stratification according to risk allows us to take the most objective behavior to label the patient as allergic to. In the natural history of penicillin allergy, 80-90 % of patients lose this sensitivity by 10 years. If necessary, the patient can undergo a desensitization protocol. The immuno-allergist is a key piece in the selection of the patient, the elaboration of the challenge and desensitization protocols, in a controlled environment.
β-内酰胺类抗生素因其安全性和有效性而成为使用最广泛的抗菌药物。这些药物包括青霉素类、头孢菌素类、碳青霉烯类和单环β-内酰胺类。青霉素过敏在药物过敏中位居首位。10%至20%的人群被标记为对其过敏,而这往往是错误的。据报道,青霉素类和头孢菌素类之间的交叉反应发生率为2%至5%。青霉素类与氨曲南之间无交叉反应,但与头孢他啶有交叉反应。Gell和Coombs分类的所有机制都包含在青霉素过敏反应的病理生理学中。根据风险进行分层使我们能够采取最客观的行为来标记患者是否过敏。在青霉素过敏的自然病程中,80%至90%的患者在10年后会失去这种敏感性。如有必要,患者可接受脱敏方案。免疫过敏专科医生在患者选择、激发试验和脱敏方案制定以及在可控环境中起着关键作用。