Allergic and immunological aspects of therapy with cefotaxime and other cephalosporins

Weck, A.L. de; Schneider, Christoph

doi:10.1093/jac/6.suppl_a.161

Cited by 7 publications

(2 citation statements)

References 5 publications

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“…Concentrations from 10 to 30 mg/mL have been recommended for intra‐dermal testing with some cephalosporins [46]. Data suggest that different patterns of positive responses may occur; while some cases develop cross‐reactivity between similar side chains [40, 43, 47], others experience a selective skin response to one cephalosporin only, and in others cross‐reactivity between penicillins and cephalosporins seems to occur [48, 49].…”

Section: Skin Testing With Other Betalactamsmentioning

confidence: 99%

Continued need of appropriate betalactam‐derived skin test reagents for the management of allergy to betalactams

Blanca¹,

Romano

Torres³

et al. 2007

Clin Experimental Allergy

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Immediate allergic reactions to betalactams (BLs) are due to IgE antibodies that recognize the ring-derived penicilloyl determinant or side-chain structures of common BLs. The presence of specific IgE antibodies can be demonstrated by skin testing, the determination of specific IgE antibodies in sera or their binding to basophils with subsequent activation upon contact with penicillins in vitro. Skin tests are still the most sensitive technique followed by in vitro tests, which may sometimes yield useful complementary information. The diversity of the response to BLs has meant that in some instances, in addition to benzylpenicillin-derived determinants, testing for amoxycillin, cephalosporins or other BLs may also be required to establish the diagnosis. The recent withdrawal from the market of BL-derived materials for skin testing will have a serious effect on public health, resulting in a return to the pre-1960 era before these reagents became available. Because of their greater sensitivity, these skin tests cannot yet be replaced by in vitro tests. Furthermore, skin tests are the most readily available form of allergy testing for physicians. This paper reviews the results of skin tests in BL allergy and provides evidence for their continued need.

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Section: Skin Testing With Other Betalactamsmentioning

confidence: 99%

Continued need of appropriate betalactam‐derived skin test reagents for the management of allergy to betalactams

Blanca¹,

Romano

Torres³

et al. 2007

Clin Experimental Allergy

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“…3O Reports of changes in hematologic parameters have been sporadic. There have been occasional reports of decreased hemoglobin6*Ie2 or positive Coomb's tests.37 Gold did not notice such changes in any Of her 77 patients.% Eosinophilia (2 500 mm3) has been reported by [67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82] Gold observed eosinophilia in 14% of those children treated for 5 days or less and in 32% of those treated for longer Also obselved in Gold's series was neutro-Penis (< 1 500/mm3 in 18% of 28 children treated for more than 5 days with cefur~xime.~~ The clinical significance of these hemtologic changes is not ap-Parent. Follow-up studies have shown normalization Of hematologic parameters once therapy is discontinued.…”

Section: Side Effects and Toxicitymentioning

confidence: 99%

Cefuroxime: Mechanisms of Action, Antimicrobial Activity, Pharmacokinetics, Clinical Applications, Adverse Reactions and Therapeutic Indications

Gold

Rodríguez

1983

Pharmacotherapy

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Cefuroxime is a second generation cephalosporin with a broad antimicrobial activity against both Gram-positive and Gram-negative organisms. It has excellent in vitro activity against staphylococcal strains, streptococcal strains (other than enterococci), N. gonorrhoaae, H. infhenzae and N. meningitidis. It also has excellent in vitro activity against members of the Enterobacteriaceae with the exception of Serratia and indole-posltive Proteus. Ps. aeruginosa and 8. tragilis are resistant. Cefuroxime is relatively free of serious side effects. It is metabolically stable, and most of it is excreted unchanged in the urine.

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Mechanism of Action, Antimicrobial Activity, Pharmacology, Adverse Effects, and Clinical Efficacy of Cefotaxime

LeFrock¹,

Prince

Left

1982

Pharmacotherapy

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Cefotaxime sodium, a parenteral cephalosporin antibiotic, exerts its bactericidal action through inhibition of bacterial cell wall synthesis. Chemical structure modifications have enabled this compound to be resistant to the action of Richmond I, III, IV, and V beta-lactamase enzymes. Excellent activity against many gram-negative bacilli, especially Enterobacteriaceae, has been demonstrated. Antipseudomonal activity is generally poor, however. Activity against gram-positive cocci, with the notable exception of Streptococcus fecalis, is adequate. Anaerobic activity is variable, particularly against Clostridia and Bacteroides species. Acute, subacute, and chronic toxicity studies in animals were generally unremarkable. No mutagenic effects or reproductive toxicity have been noted in animals. In man, cefotaxime is desacetylated to a microbiologically active metabolite. Urinary excretion is approximately 50-60% and 15-20% of a dose for the parent compound and desacetyl metabolite, respectively. The elimination half-life of cefotaxime is about one hour, with the total body clearance being approximately twice that of the renal clearance. Severe renal dysfunction causes a prolongation of the elimination half-life of cefotaxime and particularly desacetyl cefotaxime. A relatively low degree of protein binding in part attributes to a wide bodily distribution of cefotaxime. Cefotaxime is effective in a variety of infectious processes caused by susceptible organisms. Local reactions at the injection site and hypersensitivity phenomena are the most common adverse effects. Comparative trials attesting to cefotaxime's clinical utility over other parenteral cephalosporins or amino-glycosides are very limited. Based on the available evidence, cefotaxime should be most useful in combating serious gram-negative infections, because of its excellent activity against most of these organisms and its low toxicity profile.

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Allergic and immunological aspects of therapy with cefotaxime and other cephalosporins

Cited by 7 publications

References 5 publications

Continued need of appropriate betalactam‐derived skin test reagents for the management of allergy to betalactams

Continued need of appropriate betalactam‐derived skin test reagents for the management of allergy to betalactams

Cefuroxime: Mechanisms of Action, Antimicrobial Activity, Pharmacokinetics, Clinical Applications, Adverse Reactions and Therapeutic Indications

Mechanism of Action, Antimicrobial Activity, Pharmacology, Adverse Effects, and Clinical Efficacy of Cefotaxime

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