Abstract

FARINHA, Sofia; CARDOSO, Bárbara Kong; TOMAZ, Elza  and  INACIO, Filipe. Profiles of sensitization to cephalosporins in clinical practice. Rev Port Imunoalergologia [online]. 2018, vol.26, n.4, pp.263-271. ISSN 0871-9721.

Background: The estimated prevalence of hypersensitivity to cephalosporins is about 1% to 3% of general population. The allergological workup for this situation requires a proper methodology, considering the structural similarities between beta-lactam compounds, which may imply different patterns of cross-sensitization. Aims: To characterize the allergic immediate reactions to cephalosporins observed in the clinical practice concerning the clinical presentation as well as the patterns of cross-sensitization. Methods: The clinical files of 12 patients with immediate allergic reaction to a cephalosporin were searched and data regarding the clinic manifestation and allergological workup findings were recorded and analysed. Patterns of sensitization to cephalosporins and cross-sensitization were identified. Results: Nine out of twelve patients presented an anaphylactic reaction to a cephalosporin. Most of the cross-sensitization patterns observed in this group of patients seemed to be related to the betalactamic ring and in 2 cases to R2 lateral chains. Only in one patient the R1 lateral chain was involved, in spite of this one being generally seen as the main responsible for cephalosporin cross-reactions. Conclusions: In cephalosporin immediate allergy severe reactions seem to be frequent. Besides R1 lateral chains, the allergy workup must consider the betalactamic ring and theR2 lateral chains as potentially involved in cross-reactions.

Keywords : Cephalosporin; cross-sensitization; lateral chain; beta-lactams antibiotic; immediate reactions.

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