Risk of administering cephalosporin antibiotics to patients with histories of penicillin allergy.
Risk of administering cephalosporin antibiotics to patients with histories of penicillin allergy.
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发表时间：
1995-02
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通讯作者：
S. Anné;R. Reisman
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作者：
S. Anné;R. Reisman
本综述的目的是分析关于青霉素过敏患者使用头孢菌素安全性的现有相关数据，包括青霉素皮试反应的意义以及与第一代、第二代或第三代头孢菌素相关的任何差异。青霉素和头孢菌素都含有β-内酰胺环。这种结构上的相似性导致了对这些药物的交叉致敏性和青霉素过敏患者中头孢菌素类药物过敏反应风险的相当大的混淆。方法：从制药公司发布的报告和上市后的数据提供了分析的基础。结果头孢菌素类药物不良反应发生率为1%~ 10%，过敏反应发生率< 0.02%。在有青霉素过敏史的患者中，头孢菌素反应的发生率极低，如果有增加的话。第二代和第三代头孢菌素的上市后研究显示，有青霉素过敏史的患者的过敏反应没有增加。青霉素皮试不能预测有青霉素过敏史的患者对头孢菌素过敏反应的可能性。98例青霉素皮试阳性患者（1%）发生1例反应，310例阴性患者（2%）发生6例反应。结论：这些数据表明，对青霉素过敏患者使用头孢菌素类抗生素是安全的，青霉素皮试不能识别潜在的反应者。
OBJECTIVES The purpose of this review was to analyze available relevant data regarding the safety of administering cephalosporins to penicillin-allergic patients, including the significance of penicillin skin test reactions and any difference related to first, second, or third generation cephalosporins. BACKGROUND Penicillin and cephalosporins both contain a beta-lactam ring. This structural similarity has led to considerable confusion about the cross-allergenicity of these drugs and the risks of allergic reactions from cephalosporins in penicillin-allergic patients. METHODS Published reports and post-marketing data from pharmaceutical corporations provided the basis for this analysis. RESULTS The overall incidence of adverse reactions from cephalosporins ranges from 1% to 10%, with rare anaphylaxis (< 0.02%). In patients with histories of penicillin allergy the incidence of cephalosporin reactions is minimally, if at all increased. Post-marketing studies of second and third generation cephalosporins showed no increase in allergic reactions in patients with penicillin allergy histories. Penicillin skin tests do not predict the likelihood of allergic reactions to cephalosporins in patients with histories of penicillin allergy. One reaction occurred in 98 patients (1%) with positive penicillin skin tests and six reactions occurred in 310 patients (2%) with negative tests. CONCLUSIONS These data indicate that it is safe to administer cephalosporin antibiotics to penicillin-allergic patients and penicillin skin tests do not identify potential reactors.