Published online April 1, 2005
PEDIATRICS Vol. 115 No. 4 April 2005, pp. 1048-1057 (doi:10.1542/peds.2004-1276)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (33)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pichichero, M. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pichichero, M. E.
Related Collections
Right arrow Infectious Disease & Immunity
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

SPECIAL ARTICLE

A Review of Evidence Supporting the American Academy of Pediatrics Recommendation for Prescribing Cephalosporin Antibiotics for Penicillin-Allergic Patients

Michael E. Pichichero, MD

From the University of Rochester, Elmwood Pediatric Group, Rochester, New York

The American Academy of Pediatrics, evidence-based guidelines endorse the use of cephalosporin antibiotics for patients with reported allergies to penicillin, for the treatment of acute bacterial sinusitis and acute otitis media. Many physicians, however, remain reluctant to prescribe such agents. Although such concern is understandable, lack of consistent data regarding exactly what constitutes an initial penicillin-allergic reaction and subsequent cross-sensitivity to cephalosporins may be preventing many patients from receiving optimal antibiotic therapy. This article reviews evidence in support of the American Academy of Pediatrics recommendation. Included is an examination of the types and incidence of reactions to penicillins and cephalosporins; the frequency of cross-reactivity between these 2 groups of agents; experimental and clinical studies that suggest that side chain-specific antibodies predominate in the immune response to cephalosporins, thereby explaining the lack of cross-sensitivity between most cephalosporins and penicillins; the role of skin testing; and the risks of anaphylaxis. Specific recommendations for the treatment of patients on the basis of their responses to previously prescribed agents are summarized.

Key Words: penicillin • cephalosporin • allergy

Abbreviations: AAP, American Academy of Pediatrics

Accepted Aug 19, 2004.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 CirculationHome page
M. A. Gerber, R. S. Baltimore, C. B. Eaton, M. Gewitz, A. H. Rowley, S. T. Shulman, and K. A. Taubert
Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis: A Scientific Statement From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics
Circulation, March 24, 2009; 119(11): 1541 - 1551.
[Abstract] [Full Text] [PDF]

Home page
 The Annals of PharmacotherapyHome page
J. Frumin and J. C Gallagher
Allergic Cross-Sensitivity Between Penicillin, Carbapenem, and Monobactam Antibiotics: What Are the Chances?
Ann. Pharmacother., February 1, 2009; 43(2): 304 - 315.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Podiatr. Med. Assoc.Home page
R. G. Smith
Penicillin and Cephalosporin Drug Allergies: A Paradigm Shift
J Am Podiatr Med Assoc, November 1, 2008; 98(6): 479 - 488.
[Abstract] [Full Text] [PDF]

Home page
 Pediatr. Rev.Home page
C. J. Harrison and D. Bratcher
Cephalosporins: A Review
Pediatr. Rev., August 1, 2008; 29(8): 264 - 273.
[Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
N. Silverberg and S. Block
Uncomplicated Skin and Skin Structure Infections in Children: Diagnosis and Current Treatment Options in the United States
Clinical Pediatrics, April 1, 2008; 47(3): 211 - 219.
[PDF]

Home page
 Anesth. Analg.Home page
J. H. Levy and N. F. Adkinson Jr
Anaphylaxis During Cardiac Surgery: Implications for Clinicians
Anesth. Analg., February 1, 2008; 106(2): 392 - 403.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
S. Pegler and B. Healy
In patients allergic to penicillin, consider second and third generation cephalosporins for life threatening infections
BMJ, November 10, 2007; 335(7627): 991 - 991.
[Full Text] [PDF]

Home page
 PediatricsHome page
J. E. Gern
A Review of Evidence Supporting the American Academy of Pediatrics Recommendation for Prescribing Cephalosporin Antibiotics for Penicillin-Allergic Patients
Pediatrics, August 1, 2006; 118(Supplement_1): S21 - S21.
[Abstract] [PDF]

Home page
 CLIN PEDIATRHome page
M. E. Pichichero
Pathogen Shifts and Changing Cure Rates for Otitis Media and Tonsillopharyngitis
Clinical Pediatrics, July 1, 2006; 45(6): 493 - 502.
[Abstract] [PDF]