Immediate Hypersensitivity Reactions to β-Lactam Antibiotics

In this review the immune reactions to β-lactam antibiotics are discussed. The discussion is limited to the penicillin and cephalosporin families because there is little data available on the potential of the newer nonpenicillin, noncephalosporin β-lactam antibiotics to cause adverse immune reactions. However, the discussion of cross-reactivity between penicillins and cephalosporins gives some idea as to what to expect with these newer agents. This discussion dwells almost exclusively on IgE-mediated (immediate) reactions because these reactions are the most dangerous, are purported to cross-react between β-lactam antibiotics, and because concern about the occurrence of these reactions frequently prevents administration of the drug. Furthermore, we can expect the availability of prospective testing for IgE-mediated reactions in the near future.