Annè S, Reisman R E
State University of New York, Division of Allergy/Immunology, Buffalo 14203.
Ann Allergy Asthma Immunol. 1995 Feb;74(2):167-70.
The purpose of this review was to analyze available relevant data regarding the safety of administering cephalosporins to penicillin-allergic patients, including the significance of penicillin skin test reactions and any difference related to first, second, or third generation cephalosporins.
Penicillin and cephalosporins both contain a beta-lactam ring. This structural similarity has led to considerable confusion about the cross-allergenicity of these drugs and the risks of allergic reactions from cephalosporins in penicillin-allergic patients.
Published reports and post-marketing data from pharmaceutical corporations provided the basis for this analysis.
The overall incidence of adverse reactions from cephalosporins ranges from 1% to 10%, with rare anaphylaxis (< 0.02%). In patients with histories of penicillin allergy the incidence of cephalosporin reactions is minimally, if at all increased. Post-marketing studies of second and third generation cephalosporins showed no increase in allergic reactions in patients with penicillin allergy histories. Penicillin skin tests do not predict the likelihood of allergic reactions to cephalosporins in patients with histories of penicillin allergy. One reaction occurred in 98 patients (1%) with positive penicillin skin tests and six reactions occurred in 310 patients (2%) with negative tests.
These data indicate that it is safe to administer cephalosporin antibiotics to penicillin-allergic patients and penicillin skin tests do not identify potential reactors.
本综述的目的是分析有关对青霉素过敏患者使用头孢菌素安全性的现有相关数据，包括青霉素皮肤试验反应的意义以及与第一代、第二代或第三代头孢菌素相关的任何差异。
青霉素和头孢菌素都含有β-内酰胺环。这种结构相似性导致了对这些药物交叉过敏性以及青霉素过敏患者使用头孢菌素发生过敏反应风险的相当大的困惑。
已发表的报告和制药公司的上市后数据为该分析提供了基础。
头孢菌素不良反应的总体发生率为1%至10%，罕见过敏反应（<0.02%）。在有青霉素过敏史的患者中，头孢菌素反应的发生率即使有增加也微乎其微。第二代和第三代头孢菌素的上市后研究表明，有青霉素过敏史的患者过敏反应并未增加。青霉素皮肤试验无法预测有青霉素过敏史的患者对头孢菌素过敏反应的可能性。98例青霉素皮肤试验阳性的患者中有1例发生反应（1%），310例试验阴性的患者中有6例发生反应（2%）。
这些数据表明，对青霉素过敏患者使用头孢菌素抗生素是安全的，且青霉素皮肤试验无法识别潜在的过敏反应者。
