Hipersensibilidad a Betalactámicos. Dra Yurlany Gutiérrez (20 de septiembre 2018)

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Hipersensibilidad a Betalactámicos.  Dra Yurlany Gutiérrez (20 de septiembre 2018)

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  1. Ricardo Cardona Villa21 de septiembre de 2018, 9:39

    Artículo recomendado:

    Cross-reactivity in b-Lactam Allergy
    Robert J. Zagursky, PhD, and Michael E. Pichichero, MD Rochester, NY

    b-Lactam drugs (penicillins, amoxicillin, and cephalosporins)
    account for 42.6% of all severe drug-induced anaphylaxis. In this
    review, we focus on clinically significant immunologic crossreactivity
    in patients with confirmed penicillin allergy to
    cephalosporins, and the structural involvement of the R1 and R2
    chemical side chains of the cephalosporins causing IgE-mediated
    cross-reactivity with penicillin and other cephalosporins. Skin
    tests predict IgE-mediated reactions and showed cross-reactivity
    between penicillins and early generation cephalosporins that
    shared side chains, but confirmatory challenge data are lacking.
    Later-generation cephalosporins, which have distinct side chains,
    do not have any skin test cross-reactivity with penicillin/
    amoxicillin. There is debate as to the involvement of R2 side
    chains as the antigenic determinants that cause IgE-mediated
    hypersensitivity with various cephalosporins. Avoidance of
    cephalosporins, when they are the drug of choice in a penicillinallergic individual, results in significant morbidity that outweighs the low risk of anaphylaxis. We conclude that there is ample evidence to allow the safe use of cephalosporins in patients with isolated confirmed penicillin or amoxicillinallergy.

    Texto completo:
    http://dx.doi.org/10.1016/j.jaip.2017.08.027

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