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KMID : 0882420140870060652
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Korean Journal of Medicine
2014 Volume.87 No. 6 p.652 ~ p.658
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Beta-Lactam Allergy and Cross-Reactivity
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Kim Sang-Hoon
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Abstract
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Penicillins and cephalosporins are commonly prescribed beta-lactam antibiotics that are able to induce severe and sometimes even life-threatening hypersensitivity reactions. These reactions can be broadly classified as immediate or non-immediate/delayed depending on the onset of the reaction after the last drug administration. A definitive diagnosis of beta-lactam hypersensitivity is required to carry out the proper preventive measures. The diagnostic approach to beta-lactam allergy should be considered if the risk/possible benefit ratio is positive. In Korea, however, the diagnostic approach to beta-lactam allergy remains a major challenge. Major and minor determinants of penicillin for skin testing are unavailable, making skin testing appear to be less sensitive. Drug allergy work-ups that include standardized skin tests, reliable in vitro tests, and drug provocation tests are rarely carried out in clinical practice. However, screening patients without a prior history of beta-lactam allergy is routinely recommended. In this review, we discuss practical evaluation of beta-lactam allergy and cross-reactivity between penicillins and cephalosporins.
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KEYWORD
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Allergy, Hypersensitivity, Diagnosis, Penicillin, Cephalosporin
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