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Ampicillin/sulbactam is contraindicated in individuals who have a history of a penicillin allergy. Symptoms of allergic reactions may range from rash to potentially life-threatening conditions, such as anaphylaxis. Patients who have asthma, eczema, hives, or hay fever are more likely to develop undesirable reactions to any of the penicillins. [10]
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 .
Unasyn is the trade name for two related antibiotic drugs: Ampicillin/sulbactam , a fixed-dose combination medication of the penicillin antibiotic combination ampicillin/sulbactam Sultamicillin , an oral form of the penicillin antibiotic combination ampicillin/sulbactam
Sultamicillin, sold under the brand name Unasyn among others, is an oral form of the penicillin antibiotic combination ampicillin/sulbactam. It is used for the treatment of bacterial infections of the upper and lower respiratory tract , the kidneys and urinary tract , skin and soft tissues , among other organs.
The combination ampicillin/sulbactam (Unasyn) is available in the United States. [3] The combination cefoperazone/sulbactam (Sulperazon) is available in many countries but not in the United States. [4] The co-packaged combination sulbactam/durlobactam was approved for medical use in the United States in May 2023. [5]
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 ...
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.
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.