Abstract | BACKGROUND: OBJECTIVE: DESIGN: Prospective study in patients without clinical indications for cephalosporin treatment. SETTING: Italy. PATIENTS: MEASUREMENTS: RESULTS: 14 patients (10.9% [95% CI, 6.1% to 17.7%]) had positive results on skin tests for cephalosporins, mostly for cephalothin or cefamandole. Skin test results for the minor determinant mixture were positive in 10 of 14 patients (71.4%) with cross-reactivity and 44 of 114 patients (38.6%) without cross-reactivity (odds ratio, 3.90 [CI, 1.17 to 13.40]; P = 0.0189). All 101 patients with negative results on skin tests for cefuroxime, ceftazidime, ceftriaxone, and cefotaxime tolerated cefuroxime axetil and ceftriaxone (tolerability rate, 100% [CI, 96.4% to 100%]). LIMITATIONS: Challenges were not followed by full therapeutic courses. Twenty-two patients declined challenges; positive responses in those patients would have decreased the tolerability rate to 82.1% (CI, 74.2% to 88.4%). CONCLUSIONS: These data confirm the advisability of avoiding cephalosporin treatment in patients with positive results on skin tests for penicillin. In patients who especially require cephalosporin treatment, we recommend skin tests with cephalosporins before assessing the tolerability of the cephalosporin with a graded challenge.
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Authors | Antonino Romano, Rosa-Maria Guéant-Rodriguez, Marinella Viola, Rosa Pettinato, Jean-Louis Guéant |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 141
Issue 1
Pg. 16-22
(Jul 06 2004)
ISSN: 1539-3704 [Electronic] United States |
PMID | 15238366
(Publication Type: Journal Article)
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Chemical References |
- Cephalosporins
- Penicillins
- Immunoglobulin E
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Topics |
- Adult
- Cephalosporins
(adverse effects, immunology)
- Cross Reactions
- Female
- Humans
- Hypersensitivity, Immediate
(chemically induced, immunology)
- Immunoglobulin E
(blood)
- Male
- Middle Aged
- Penicillins
(adverse effects, immunology)
- Prospective Studies
- Risk Factors
- Skin Tests
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