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The contraindication, however, should be viewed in the light of recent epidemiological work suggesting, for many second-generation (or later) cephalosporins, the cross-reactivity rate with penicillin is much lower, having no significantly increased risk of reactivity over the first generation based on the studies examined.
Nevertheless, the risk of cross-reactivity is sufficient to warrant the contraindication of all β-lactam antibiotics in patients with a history of severe allergic reactions (urticaria, anaphylaxis, interstitial nephritis) to any β-lactam antibiotic. Rarely, allergic reactions have been triggered by exposure from kissing and sexual contact ...
If someone has developed side effects when taking penicillin, these side effects may develop with a new medication even though the person has not taken the new medication before. Those medications that may cause a cross sensitivity reaction are: carbapenems, ampicillin, cefazolin, cephalosporins and cloxacillin. [9] [8] [10]
Side effects associated with use of cefazolin therapy include: [8] Common (1–10%): diarrhea, stomach pain or upset stomach, vomiting, and rash. Uncommon (<1%): dizziness, headache, fatigue, itching, transient hepatitis. [13] Patients with penicillin allergies could experience a potential reaction to cefazolin and other cephalosporins. [8]
Monobactam antibiotics exhibit no IgE cross-reactivity reactions with penicillin but have shown some cross reactivity with cephalosporins, most notably ceftazidime, which contains an identical side chain as aztreonam. [9] Monobactams can trigger seizures in patients with history of seizures, although the risk is lower than with penicillins.
Cross-reactivity, in a general sense, is the reactivity of an observed agent which initiates reactions outside the main reaction expected. This has implications for any kind of test or assay , including diagnostic tests in medicine, and can be a cause of false positives .
Penicillin-sensitive patients may also be allergic to the cephalosporins, depending on the side chain and it's relation to the penicillin allergy. Most patients with penicillin allergy can tolerate the majority of cephalosporins without allergic reactions. The previous percentage of 10% cross reactivity rates are a gross overestimation. [7]
In the synergistic response, the applied antibiotics work together to produce an effect more potent than if each antibiotic were applied singly. [1] Compare to the additive effect , where the potency of an antibiotic combination is roughly equal to the combined potencies of each antibiotic singly, and antagonistic effect, where the potency of ...