ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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| Title |
Minimal Risk Of Severe Type 1 Hypersensitivity Reaction To Third Generation Cephalosporin In Patients Who Experience Type 1 Hypersensitivity Reaction And Allergy To Penicillin |
| Clinical Question |
Do patients who experience a severe type 1 hypersensitivity reaction to penicillin and demonstrate an allergy to cephalosporin experience a severe type 1 hypersensitivity reaction to the cephalosporin? |
| Clinical Bottom Line |
It appears that patients who have a severe type 1 hypersensitivity reaction to penicillin do not have an increased risk of anaphylaxis to cephalosporins. This evidence may be skewed however by adherence to the recommendation not to give cephalosporins to individuals with a history of penicillin anaphylaxis. (See Comments on the CAT below) |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 18159398 | Hameed/2002 | Focused on Children, but adult information also included. | Systematic Review of Case Reports | | Key results | No anaphylaxis to a cephalosporin has ever been reported in children, there have been 12 reports of anaphylaxis from cephalosporins in adults with a history of penicillin allergy or a positive penicillin skin test, but with no history of anaphylaxis from penicillin. | |
| Evidence Search |
#2Search Anaphylaxis and penicillin and cephalosporin and cross-reactivity |
Comments on
The Evidence |
The article used was a systematic review of case reports |
| Applicability |
The evidence is applicable to both adult and child patients with penicillin allergies. |
| Specialty/Discipline |
(Endodontics) (General Dentistry) (Oral Surgery) (Pediatric Dentistry) (Periodontics) (Prosthodontics) |
| Keywords |
Anaphylaxis, Penicillin, Cephalosporin, Cross-reactivity
|
| ID# |
848 |
| Date of submission: |
04/12/2011 |
| E-mail |
gruberj@livemail.uthscsa.edu |
| Author |
Joshua Gruber |
| Co-author(s) |
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| Co-author(s) e-mail |
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| Faculty mentor/Co-author |
Ernest Valdez, DDS |
| Faculty mentor/Co-author e-mail |
VALDEZE@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Julie Berkhoff (CO) on 08/04/2011
A more recent systematic review published in 2008 by the Journal of the American Pharmacists Association (PubMed: 18653431) confirmed a very low incidence of cross-reactivity based on oral re-challenge and skin testing to verify true allergic reaction vs non-allergic adverse reaction. This study included both animal and human studies. | |
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