Vnitr Lek 2024, 70(2):E24-E31 | DOI: 10.36290/vnl.2024.029

Antibiotic treatment of patients hypersensitive to penicillin and β-lactam antibiotics

Martin Sučík, Róbert Rosoľanka, Dušan Krkoška, Katarína Šimeková

Klinika infektológie a cestovnej medicíny, Univerzitná nemocnica Martin a Jesseniova lekárska fakulta Univerzity Komenského, Martin

Presumed or confirmed hypersensitivity to penicillins is a common problem in clinical practice. Knowledge about the nature of cross-reactivity of the immune system to various β-lactam antibiotics has increased considerably over the years. The original notion of a high degree of cross-reactivity between the major groups of β-lactam antibiotics was based on the presence of a common β-lactam ring in their molecule. However, the conclusions of recent clinical observations and studies suggest that the match or similarity of the side chains bound to the β-lactam ring plays a dominant role in the development of cross-reactivity between β-lactam antibiotics. Therefore, knowledge of the basic structural properties of β-lactams may help to eliminate the frequent and, in many cases, groundless concerns about the use of most available cephalosporins in patients with a history of hypersensitivity to penicillins. This article summarizes the current knowledge of the risks of cross-reactivity between different groups of β-lactam antibiotics. It also conveys recommendations for the management of patients with a history of penicillin hypersensitivity based on the current literature.

Keywords: allergy, β-lactam antibiotics, side chains, hypersensitivity, penicillin, cross-reactivity.

Accepted: April 10, 2024; Published: April 10, 2024  Show citation