IgE-Mediated Hypersensitivity Reactions to Cephalosporins

Baek-Nam Kim; You Sook Cho

doi:10.3947/ic.2010.42.3.137

Journal List > Infect Chemother > v.42(3) > 1034998

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This article has been corrected. See "ERRATUM: IgE-Mediated Hypersensitivity Reactions to Cephalosporins" in Volume 42 on page 434.

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Kim and Cho: IgE-Mediated Hypersensitivity Reactions to Cephalosporins

Review Article

Infection & Chemotherapy

Infection & Chemotherapy 2010; 42(3): 137-142.

Published online: 30 June 2010

DOI: https://doi.org/10.3947/ic.2010.42.3.137

IgE-Mediated Hypersensitivity Reactions to Cephalosporins

Baek-Nam Kim¹

, You Sook Cho²

¹Department of Internal Medicine, Inje University Sanggye-Paik Hospital, Inje Uni versity College of Medicine, Seoul, Korea.

²Division of Allergy and Clinical Immunology, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Corresponding author: Baek-Nam Kim, M.D. Department of Internal Medicine, Inje University Sanggye-Paik Hospital, Nowon-gu, Seoul 139-707, Korea. Tel: +82-2-950-8863, Fax: +82-2-950-1955, kimbn@paik.ac.kr

Received 10 May 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cephalosporins are commonly prescribed either orally or parenterally for the treatment of bacterial infections because of wide safety margin compared with penicillins. Skin testing with a parent cephalosporin antibiotic has routinely been performed in Korea in the fear of developing anaphylaxis after the administration of a cephalosporin although penicillins are antibiotics that most commonly induce severe or life-threatening IgE-mediated reactions (anaphylaxis). In this review, we will discuss IgE-mediated hypersensitivity reactions to cephalosporins. Immunopathogenesis of IgE-mediated hypersensitivity reaction to cephalosporins, limitations of skin testing with parent cephalosporin antibiotics, and prescription strategy of cephalosporins for patients with a history of cephalosporin or penicillin hypersensitivity was described.

Keywords: Cephalosporins, Penicillins, Hypersensitivity, Anaphylaxis

Figures and Tables

Figure 1

Structures of b-lactam antibiotics.

Figure 2

Matrix of penicillin and cephalosporin drugs with similar side-chain structures. 3, similarity at the cephalosporin 3-position side chain; 7, similarity at the cephalosporin 7-position side chain; 6/7, similarity at the penicillin 6-position side chain and the cephalosporin 7-position side chain. Drugs with 3-position or 7-position side chains dissimilar than any other include cefazolin, cefonicid, cefotiam, and moxalactam (13).

Table 1

Strategy for Using Cephalosporin Antibiotics Based on Current Situation in Korea

^*Cephalosporin skin test without specific reason in patients who are going to receive a cephalosporin is not recommended.

^†We do not consider desensitization of cephalosporins as an alternative for this case because it is not practical and unacceptable given the culture and condition surrounding medical practice in Korea.

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ORCID iDs

Baek-Nam Kim
https://orcid.org/http://orcid.org/0000-0001-5551-2132

You Sook Cho
https://orcid.org/http://orcid.org/0000-0001-8767-2667

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