Eker Nursah, Kutluk Gunsel, Cetinkaya Feyzullah
Department of Pediatrics, Marmara University Faculty of Medicine, Istanbul, Türkiye.
Department of Pediatrics, University of Health Sciences Türkiye, Basaksehir Cam ve Sakura City Hospital, Istanbul, Türkiye.
Sisli Etfal Hastan Tip Bul. 2024 Jun 28;58(2):155-158. doi: 10.14744/SEMB.2024.08286. eCollection 2024.
The cross-reactivity problem between cephalosporins and penicillins has mainly been evaluated in the context of patients allergic to penicillins. However, we have little data regarding the opposite aspect of the problem, i.e. the cross-reactivity in subjects primarily sensitized to cephalosporins. This prospective study aims to evaluate the cross-reactivity to penicillins and some other cephalosporins in patients with immediate allergic reactions to cephalosporins.
The study included 21 children with immediate allergic reactions to at least one cephalosporin. Skin testing was performed with a panel of minor and major determinant mixtures of penicillins and three commonly used cephalosporins (cephazoline, cefuroxime and ceftriaxone).
The children had used 5.14±4.91 (1-15) times any beta-lactam antibiotic in the previous year and the most common cephalosporins accused were ceftriaxone (42.92%), and cefuroxime, cefazolin, cefixime, cefprozil and cefotaxime (9.5% each). Skin tests were positive for any cephalosporin in 14 (66.7%) subjects and penicillin allergens in 15 (71.4%) subjects. Totally, 85.7% of children with a positive allergy history to cephalosporins were found to be sensitive to either penicillin or any one of three cephalosporins.
There seems to be a high risk of adverse reactions to penicillins and other cephalosporins in children with a history of type I hypersensitivity reaction to cephalosporins. Therefore, skin testing with both cephalosporins and penicillins should be performed in patients with a history of cephalosporin allergy.
头孢菌素与青霉素之间的交叉反应问题主要是在对青霉素过敏的患者中进行评估的。然而，我们对于该问题的相反方面，即主要对头孢菌素致敏的受试者中的交叉反应的数据很少。这项前瞻性研究旨在评估对头孢菌素发生速发型过敏反应的患者对青霉素和其他一些头孢菌素的交叉反应。
该研究纳入了21名对至少一种头孢菌素有速发型过敏反应的儿童。用一组青霉素的次要和主要决定簇混合物以及三种常用头孢菌素（头孢唑林、头孢呋辛和头孢曲松）进行皮肤试验。
这些儿童在上一年使用β-内酰胺类抗生素的次数为5.14±4.91（1 - 15次），最常被指控的头孢菌素是头孢曲松（42.92%），头孢呋辛、头孢唑林、头孢克肟、头孢丙烯和头孢噻肟各占9.5%。14名（66.7%）受试者对任何头孢菌素皮肤试验呈阳性，15名（71.4%）受试者对青霉素过敏原皮肤试验呈阳性。总的来说，85.7%有头孢菌素过敏史阳性的儿童被发现对青霉素或三种头孢菌素中的任何一种敏感。
对头孢菌素有I型超敏反应病史的儿童对青霉素和其他头孢菌素似乎有很高的不良反应风险。因此，有头孢菌素过敏史的患者应同时进行头孢菌素和青霉素的皮肤试验。
