cefamandole and Drug-Hypersensitivity

Recent analysis of clinical data and a clearer understanding of the role of chemical structure in the development of cross-reactivity indicate that the increased risk of an allergic reaction to a cephalosporin in penicillin-allergic patients is smaller than previously postulated.. Medline and EMBASE databases were searched with the keywords: cephalosporin, penicillin, allergy, and cross-sensitivity for the years 1960 through 2005. Among 219 articles retrieved, 9 served as source material for this evidence-based meta-analysis.. A significant increase in allergic reactions to cephalothin (odds ratio [OR] = 2.5; 95% confidence interval [CI] = 1.1 to 5.5), cephaloridine (OR = 8.7; CI = 5.9 to 12.8), and cephalexin (OR = 5.8; CI = 3.6 to 9.2), and all first generation cephalosporins plus cefamandole (OR = 4.8; CI = 3.7 to 6.2) were observed in penicillin allergic patients; no increase was observed with second generation cephalosporins (OR = 1.1; CI, 0.6 to 2.1) or third generation cephalosporins (OR = 0.5; CI = 0.2 to 1.1). Clinical challenges, skin testing, and monoclonal antibody studies point to the paramount importance of similarities in side chain structure to predict cross-allergy between cephalosporins and penicillins.. First-generation cephalosporins have cross-allergy with penicillins, but cross-allergy is negligible with second- and third-generation cephalosporins. Particular emphasis should be placed on the role of chemical structure in determining the risk of cross-reactivity between specific agents.

Topics: Anti-Bacterial Agents; Antibodies, Monoclonal; Cefamandole; Cephalexin; Cephaloridine; Cephalosporins; Cross Reactions; Drug Hypersensitivity; Evidence-Based Medicine; Humans; Immunoglobulin E; Penicillins; Safety

Topics: Bacteria; Bacterial Infections; Cefamandole; Cefoxitin; Cephalosporins; Cephalothin; Drug Hypersensitivity; Humans; Injections

The cephalosporin antibiotics have been employed with increasing frequency since their introduction into clinical practice in the early 1960s. With the exception of cephaloridine, cephalosporin compounds are not associated with the production of significant untoward effects. The availability of newer cephalosporins, both oral and parenteral, with enhanced antibacterial activity, has expanded the clinical indications for administration of these antibiotics.

Topics: Cefaclor; Cefamandole; Cefatrizine; Cefazolin; Cefoxitin; Cefuroxime; Cephacetrile; Cephalexin; Cephaloglycin; Cephaloridine; Cephalosporins; Cephalothin; Cephapirin; Drug Hypersensitivity; Humans; Kidney Diseases

Topics: Anaphylaxis; Anesthesia; Anesthetics; Cefamandole; Cephalosporins; Drug Hypersensitivity; France; Hospitals, Satellite; Hospitals, University; Humans; Incidence; Informed Consent; Intraoperative Complications; Latex Hypersensitivity; Preoperative Care; Referral and Consultation

Topics: Cefamandole; Drug Hypersensitivity; Exudates and Transudates; Female; Humans; Knee Joint; Middle Aged