Glässner Andreas, Dubrall Diana, Wurpts Gerda, Deck Philipp, Weindl Günther, Heubach Caspar A, Yazdi Amir S, Sachs Bernhardt
Research Division, Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany.
Institute for Medical Biometry, Informatics and Epidemiology, University Hospital of Bonn, Bonn, Germany.
Front Allergy. 2025 Mar 27;6:1532775. doi: 10.3389/falgy.2025.1532775. eCollection 2025.
Cefuroxime allergy may present as a delayed-type reaction or as an immunoglobulin (Ig)E-mediated immediate-type anaphylactic reaction. The basophil activation test (BAT) is a diagnostic tool for cefuroxime-induced immediate-type reactions, whereas the lymphocyte transformation test (LTT) is typically applied in delayed-type drug allergy. This study aimed to compare the results of the BAT and LTT in 15 patients with cefuroxime-induced anaphylactic reactions considered as confirmed. The pharmacoepidemiological part aimed to analyze spontaneous reports of cefuroxime-associated anaphylactic reactions in the European adverse drug reaction database (EudraVigilance).
In EudraVigilance, 668 reports of cefuroxime-associated anaphylactic reactions for the European Economic Area (EEA) between 2010 and 2023 were analyzed, with 182 (27.2%) of these reports originating from Germany. The BAT and the LTT were performed according to standard protocols. Except for one patient, all BAT were performed prior to the skin tests, whereas all LTT were performed thereafter.
Almost all reports were classified as serious (EEA, 99.3%; Germany, 98.9%). In 60.8% (EEA) and 66.9% (Germany) of reports with respective information, the reaction occurred after intravenous administration. BAT was performed in 12 of 15 patients (3/12 positive; sensitivity 25%), while LTT was performed in all 15 patients (7/15 positive; sensitivity 46.7%).
Our analysis highlights the importance of cefuroxime-associated anaphylactic reactions, as almost all of the spontaneous reports were classified as serious. Neither a negative BAT nor LTT can rule out a sensitization in cefuroxime-induced anaphylactic reactions.
头孢呋辛过敏可能表现为迟发型反应或免疫球蛋白（Ig）E介导的速发型过敏反应。嗜碱性粒细胞活化试验（BAT）是诊断头孢呋辛引起的速发型反应的工具，而淋巴细胞转化试验（LTT）通常用于迟发型药物过敏。本研究旨在比较15例已确诊的头孢呋辛引起过敏反应患者的BAT和LTT结果。药物流行病学部分旨在分析欧洲药品不良反应数据库（EudraVigilance）中头孢呋辛相关过敏反应的自发报告。
在EudraVigilance中，分析了2010年至2023年期间欧洲经济区（EEA）668例头孢呋辛相关过敏反应报告，其中182例（27.2%）报告来自德国。BAT和LTT按照标准方案进行。除1例患者外，所有BAT均在皮肤试验前进行，而所有LTT均在皮肤试验后进行。
几乎所有报告都被归类为严重（EEA，99.3%；德国，98.9%）。在有相应信息的报告中，60.8%（EEA）和66.9%（德国）的反应发生在静脉给药后。15例患者中的12例进行了BAT（3/12阳性；敏感性25%），而所有15例患者均进行了LTT（7/15阳性；敏感性46.7%）。
我们的分析强调了头孢呋辛相关过敏反应的重要性，因为几乎所有自发报告都被归类为严重。BAT或LTT阴性均不能排除头孢呋辛引起的过敏反应中的致敏情况。
