Allergy to cloxacillin with normal tolerance to amoxicillin and cefuroxime.

Abstract

BACKGROUND:

Cloxacillin is a semisynthetic penicillin widely used in nonmethicillin resistant Staphylococcus aureus infections. Several hypersensitivity reactions to cloxacillin have been reported, although IgE-mediated allergic reactions to the drug are rare and there is little information about possible tolerance to other semisynthetic penicillins or cephalosporins in patients with cloxacillin allergy. We present 2 patients with demonstrated IgE-mediated allergy to cloxacillin and tolerance to amoxicillin and cefuroxime.

CASE REPORTS:

Case 1. A 47-year-old woman began treatment with cloxacillin due to acute cellulitis. After ingesting 500 mg of the drug, she experience generalized maculopapular eruption and facial angioedema. Case 2. A 55-year-old woman presented an episode of acute urticaria and labial angioedema 60 minutes after ingesting 500 mg of cloxacillin for a skin abscess.

METHODS AND RESULTS:

Skin prick tests were positive to cloxacillin in case 1 and negative in case 2. However, an intradermal test was positive to cloxacillin (2 mg/ml) in case 2. Simple-blind oral challenge tests with amoxicillin (1 g) and cefuroxime (500 mg) were well-tolerated by both patients.

CONCLUSIONS:

We present 2 patients allergic to cloxacillin with normal tolerance to other betalactam antibiotics, confirming that cross-reactivity among these antibiotics seems to be uncommon. Complete allergy study, including an oral challenge test, should be considered in these patients.

• Authors: J Domínguez-Ortega, J C Martínez-Alonso, M C Marcos-Pérez, C Kindelan, A Frades
• Journal: Allergologia et immunopathologia (Allergol Immunopathol (Madr)) 2006 Jan-Feb Vol. 34 Issue 1 Pg. 37-8 ISSN: 0301-0546 [Print] Singapore
• PMID: 16540070 (Publication Type: Case Reports, Comparative Study, Journal Article)

Chemical References

• Amoxicillin
• Cefuroxime
• Cloxacillin

Topics

• Abscess (drug therapy)
• Amoxicillin
• Angioedema (chemically induced)
• Cefuroxime
• Cellulitis (drug therapy)
• Cloxacillin (adverse effects, therapeutic use)
• Drug Eruptions (etiology)
• Female
• Humans
• Intradermal Tests
• Middle Aged
• Single-Blind Method
• Skin Tests