cefotaxime and Anaphylaxis

Intrauterine fetal death and maternal shock occurred as a result of a type-1 hypersensitivity reaction following antibiotic prophylaxis in a cesarean section. Amniotic fluid embolism may mimic the condition. The ability to diagnose and treat such an event as early as possible is necessary in all maternity centers. The selection of antibiotic regimen and the type of anesthesia should be individualized depending upon the existing facilities and the patient's profile, especially in a resource-scarce developing country.

Topics: Adult; Anaphylaxis; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cefotaxime; Cesarean Section; Female; Fetal Death; Humans; Infant, Newborn; Pregnancy

Cefuroxime is a second-generation lactamase-stable cephalosporin. Its use is on the increase, and in recent years several reactions to this compound have been reported.. To describe a case of selective reaction to cefuroxime, showing a boosted immunoglobulin (Ig)E response after administration of this drug.. Specific serum IgE antibodies to several cephalosporins were monitored in a 52-year-old man after a selective systemic anaphylaxis attributable to cefuroxime, who showed a good tolerance to penicillin V during a single-blind, placebo-controlled challenge.. Specific IgE levels to cefuroxime were not detected at the moment of the reaction but became positive 1 day after, increasing to peak at day 51, and still positive after 115 days. Through radioallergosorbent test inhibition, cross-reactivity between cefuroxime and cefotaxime was demonstrated.. IgE-mediated reaction attributable to cefuroxime with cross-reactivity to cefotaxime was reported. A prompt evaluation undertaking skin tests and additional radioallergosorbent test studies with different betalactam derivatives improves the evaluation of subjects with allergic reactions to betalactams.

Topics: Anaphylaxis; Cefotaxime; Cefuroxime; Cephalosporins; Cross Reactions; Drug Hypersensitivity; Humans; Immunoglobulin E; Male; Middle Aged

Antibiotic prophylaxis is a routine procedure in management of burns. As such it is a safe practice, yet unusual complications can occur with the use of even safest antibiotics and their emergency management may be life saving. Here we present a case of 35% second and third degree burns who was taken for a second sitting of stamp grafting for remnant raw areas, who was administered intraoperative prophylactic antibiotic, developed a series of unusual complications sequentially, which were life threatening. Prompt recognition of signs and symptoms of adverse reactions of the drug used and timely management resulted in the successful outcome. A good team effort by surgeon, anaesthetist and the physician was mandatory.

Topics: Adult; Anaphylaxis; Antibiotic Prophylaxis; Burns; Cefotaxime; Cephalosporins; Disseminated Intravascular Coagulation; Drug Hypersensitivity; Female; Humans; Injections, Intravenous; Postoperative Hemorrhage; Skin Transplantation

Topics: Adolescent; Anaphylaxis; Anti-Bacterial Agents; Anti-Infective Agents; Cefixime; Cefotaxime; Drug Hypersensitivity; Drug Tolerance; Female; Humans

The antigenicity studies of a beta-lactam antibiotic, cefodizime sodium (THR-221), were examined in mice and guinea pigs and the following results were obtained. 1) In passive cutaneous anaphylaxis (PCA) with sera from BALB/c or C3H/He mice, a slight PCA reaction was observed only in BALB/c mice by using THR-221-ovalbumin (OVA) plus Freund's complete adjuvant (FCA) as the immunogen and THR-221 itself as the eliciting antigen. 2) Immunological cross-reactivity between THR-221 and CTX was present at the rat PCA reaction. 3) Antibodies against THR-221 were detected by PCA in guinea pigs. The anti-THR-221 antibodies gave PCA responses smaller than those of CMZ by using antibiotic plus FCA as the immunogen and the antibiotic-bovine serum albumin (BSA) as the eliciting antigen. 4) In the observation of active systemic anaphylaxis (ASA), no symptoms were observed in guinea pigs sensitized with THR-221 and provoked with THR-221-BSA. On the other hand, guinea pigs sensitized with THR-221 plus FCA by injecting THR-221-BSA showed fetal anaphylactic reactions. 5) The results of passive hemagglutination (PHA) also indicated that the PHA titer of THR-221 was lower than that of CMZ. 6) Protein binding property of THR-221 with human serum albumin was lower than other beta-lactam antibiotics. 7) Antibodies against THR-221-OVA by using THR-221-BSA as the eliciting antigen were detected in any tests above mentioned. It is concluded from these results that immunological activity of THR-221 was equivalent to the other beta-lactam antibiotics.

Topics: Anaphylaxis; Animals; Anti-Bacterial Agents; Antibodies; Antigens; Cefotaxime; Cross Reactions; Guinea Pigs; Hemagglutination Tests; Male; Mice; Mice, Inbred BALB C; Mice, Inbred C3H; Passive Cutaneous Anaphylaxis; Protein Binding; Rats; Rats, Inbred Strains; Serum Albumin