Purpose Of Review: To review the most recent literature studying the classifications, immunochemistry, and crossreactivity of allergy reactions to cephalosporins.
Recent Findings: Over the last five years, research interest has focused on three areas related to cephalosporin allergy: cross-reactivity among cephalosporins and with other beta-lactams; the incidence of adverse reactions in penicillin allergy patients or in reported penicillin allergy labels; and new cephalosporins structures involved in the immunological recognition.
Summary: Meta-analysis of a substantial number of studies shows that cephalosporins are safer than previously thought. Evidence supports two main conclusions in that regard. First, there is a relatively low percentage of cross-reactivity between cephalosporins and other beta-lactams with penicillins in penicillin allergy patients. Second, there is a very low incidence of allergy reactions in nonselected as well as in selected penicillin allergy patients when cephalosporins are used prior to surgical intervention.On the other hand, few structures have been discovered related to the immune mechanism of cephalosporin allergy reactions, and these are far from being ready to use in clinical practice.
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http://dx.doi.org/10.1097/ACI.0000000000000755 | DOI Listing |
JAC Antimicrob Resist
February 2025
Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Background: Antimicrobial resistance (AMR) is caused by the use and misuse of antibiotics. AMR is a global health concern, to which penicillin allergy (penA) labels appear to contribute. Patients who have penA labels are treated with non-penicillin antibiotics and receive more antibiotics when compared with patients without penA.
View Article and Find Full Text PDFFront Pharmacol
January 2025
Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Background: To date, several studies have demonstrated that erroneous labeling of Penicillin allergy (PAL) can significantly impact treatment options and result in adverse clinical outcomes, while other studies have reported no negative effects. Therefore, to systematically evaluate these effects and investigate the association between adverse clinical outcomes and the Penicillin label, we conducted this meta-analysis.
Method: Searches were conducted in the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to 13 July 2024.
J Allergy Clin Immunol Glob
February 2025
Section of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn.
Background: Cefazolin is the most common first-line antibiotic to prevent surgical-site infections. Patients with penicillin allergy labels often receive alternative antibiotics, which is associated with increased rates of surgical-site infections, multi-drug-resistant infections, and cost.
Objective: We sought to determine whether a hospital-wide guideline recommending first-line surgical prophylaxis in patients with penicillin allergy labels can increase the use of cefazolin without compromising safety.
Introduction: Erroneous penicillin allergy labels are associated with significant health and economic costs. This study aimed to determine whether deep learning-facilitated proactive consultation to facilitate delabelling may further enhance inpatient penicillin allergy delabelling.
Methods: This prospective implementation study utilised a deep learning-guided proactive consultation service, which utilized an inpatient penicillin allergy delabelling protocol.
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