Slovenská chirurgia 1/2021

Cross-reactivity between penicillins and cephalosporins - a significant problem in antibiotic prophylaxis and treatment?

Pennicillins are one of the most prescribed antibiotics and thus, not rarely a cause of allergic reactions with variable clinical manifestation, including life-threatening anaphylactic shock. Aminopenicillins, together with cephalosporins, belong to betalactam antibiotics group in which cross-reactivity is expected. As a result, if patient is allergic to one betalactam antibiotic, usually all other betalactam antibiotics are contraindicated which cannot be considered evidence-based approach anymore. Understanding proper way of allergic history assessment, mechanisms of cross-reactivity, clinical presentation of particular types of allergic reactions, as well as their incidence and clinical relevance, makes it possible to establish realistic risk of allergic cross-reaction and optimal selection of alternative antibiotic treatment in patients with allergy to penicillins or cephalosporins.

Keywords: antibiotics, allergy, cross-reactivity, penicillin, cephalosporin