Cross-Allergy Among the 6-lactam Antibiotic Agents: METHODS
Two databases — MEDLINE (from 1994 to 2004 for penicillins and cephalosporins and from 1985 to 2004 for carbapenems) and Reactions (from 1983 to 2003) — were searched for pertinent English- language articles (limited to human studies). The MeSH terms “drug hypersensitivity”, “penicillins”, “cephalosporins”, and “carbapenems” and the key words “allergy”, “imipenem”, “meropenem”, and “ertapenem” were used. The bibliographies of articles identified in this way were also reviewed and pertinent references retrieved. Because true “allergic” reactions are IgE-mediated, this mechanism was the focus of the review.
For each £-lactam class, information regarding the risks of cross-allergy is presented, followed by a concise summary or “take-home message” of the information (in italic text). Although aztreonam, a monobactam, also falls within the £-lactam family, it is not discussed here, as it is not available in Canada and, except for rare case reports, it is not considered cross-reactive in patients allergic to penicillins or cephalosporins.
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