zulooht.blogg.se - Cross reactivity between penicillin and cephalosporins

Cross reactivity between penicillin and cephalosporins skin#

For cytopenias, acute kidney or drug-induced liver injury: discuss with local paediatric team or drug allergy service.

For suspected severe cutaneous adverse reaction (SCAR)*: avoid all β-lactams.

No specific examination required – be guided by current presentation ManagementĪpproach to the child with reported penicillin or cephalosporin allergy

Past history of other drug and non-drug allergies.

Antibiotics previously tolerated (especially those after the reported reaction).

Concurrent illness (eg possible viral infection).

Required immediate treatment (eg adrenaline auto injector, bronchodilator).

Airway angioedema (mouth, eyes, lips, or tongue).

Respiratory symptoms (eg wheeze, stridor or increased work of breathing).

Rash (eg non-specific, maculopapular, urticarial).

Duration of symptoms and time to recovery.Symptoms occur 1 hour after ingestion (= delayed).More than 90% of children with non-immediate β-lactam reactions do not have a reproducible ‘allergic’ reaction when re-challenged with the same drugĪ detailed history of the timing, nature and severity of the previous reaction (including the potential for a severe, IgE-mediated reaction) is essential History.β-lactam antibiotics (including penicillins, cephalosporins, carbapenems) are the most commonly implicated.Up to a quarter of all children presenting to hospital will report an antibiotic allergy.

Cross reactivity between penicillin and cephalosporins skin#

Drug allergy testing (drug challenge or skin testing) should take place in controlled settings.Children with a history of non-immediate and non-severe reactions can be prescribed an antibiotic from an alternate β-lactam class.Children with a history of an immediate or severe reaction to either a penicillin or cephalosporin should avoid drugs from both β-lactam classes.A detailed drug allergy history should be taken to help make appropriate antibiotic choices.Local antimicrobial guidelines Anaphylaxis Urticaria Serum Sickness and Serum Sickness like reactions (SSLRs) Key points