Beta-Lactam Cross Allergy

Beta-Lactam Cross Allergy

Lists below indicate side-chain and/or major/minor antigenic similarity between antibiotics

This should only be used to evaluate the risk of cross-reactivity in patients with type 1 immediate (IgE-mediated) hypersensitivity reactions to a beta-lactam (e.g. anaphylaxis, urticaria, angioedema, hypotension, bronchospasm, stridor, pruritis)

For type-1 immediate hypersensitivity there is a risk of cross-allergenicity between pairs due to similar side-chains and/or major/minor antigenic determinants, use NOT recommended without desensitization

  • For example: a patient allergic to amoxicillin would likely manifest a reaction to ampicillin, cloxacillin, piperacillin, ticarcillin, cefadroxil, cephalexin, cefaclor and cefprozil but NOT to ceFAZolin, cefuroxime or cefTRIAXone, etc.

Penicillins

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Amoxicillin

  • Ampicillin

  • Cloxacillin

  • Piperacillin

  • Ticarcillin

  • Cephalothin

  • cefOXitin

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Penicillin

  • Ampicillin

  • Cloxacillin

  • Piperacillin

  • Ticarcillin

  • Cefadroxil

  • Cephalexin

  • Cefaclor

  • Cefprozil

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Penicillin

  • Amoxicillin

  • Cloxacillin

  • Piperacillin

  • Ticarcillin

  • Cefadroxil

  • Cephalexin

  • Cefaclor

  • Cefprozil

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Penicillin

  • Amoxicillin

  • Ampicillin

  • Piperacillin

  • Ticarcillin

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Penicillin

  • Amoxicillin

  • Ampicillin

  • Cloxacillin

  • Ticarcillin

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Penicillin

  • Amoxicillin

  • Ampicillin

  • Cloxacillin

  • Piperacillin

1st Generation Cephalosporin

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Amoxicillin

  • Ampicillin

  • Cephalexin

  • Cefaclor

  • Cefprozil

No antibiotics with side-chain and/or major/minor antigenic similarity

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Amoxicillin

  • Ampicillin

  • Cefadroxil

  • Cefaclor

  • Cefprozil

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Penicillin

  • cefOXitin

  • Cefotaxime

2nd Generation Cephalosporin

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Amoxicillin

  • Ampicillin

  • Cefadroxil

  • Cephalexin

  • Cefprozil

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Amoxicillin

  • Ampicillin

  • Cefadroxil

  • Cephalexin

  • Cefaclor

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • cefOXitin

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Penicillin

  • Cephalothin

  • Cefuroxime

3rd Generation Cephalosporin

No antibiotics with side-chain and/or major/minor antigenic similarity

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Cephalothin

  • cefTRIAXone

  • Cefepime

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Aztreonam

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Cefotaxime

  • Cefepime

4th Generation Cephalosporin

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Cefotaxime

  • cefTRIAXone

Carbapenems

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Imipenem

  • Ertapenem

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Meropenem

  • Ertapenem

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • Meropenem

  • Imipenem

Monobactam

Antibiotics that have a similar side chain or structure and a higher risk for cross-reactivity, use NOT recommended without desensitization:

  • cefTAZidime