Absence of cross-reactivity to carbapenems in patients with delayed hypersensitivity to penicillins

A. Romano, F. Gaeta, R. L. Valluzzi, C. Alonzi, M. Maggioletti, A. Zaffiro, C. Caruso, D. Quaratino

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Studies performed on subjects with IgE-mediated hypersensitivity to penicillins have demonstrated a 1% rate of cross-reactivity between penicillins and both imipenem and meropenem, while a single study found a 5.5% rate of cross-reactivity with imipenem/cilastatin in subjects with T-cell-mediated hypersensitivity to β-lactams, mostly penicillins. We studied 204 consecutive subjects with a well-demonstrated T-cell-mediated hypersensitivity to assess the cross-reactivity with carbapenems and the tolerability of such alternative β-lactams. All 204 subjects underwent skin tests with imipenem/cilastatin and meropenem; 130 of them were skin-tested also with ertapenem. Subjects with negative test results were challenged with these carbapenems. All subjects displayed negative skin tests to carbapenems and tolerated challenges. These data demonstrate the absence of clinically significant T-cell-mediated cross-reactivity between penicillins and carbapenems. Negative delayed-reading skin testing with carbapenems in individuals with documented T-cell-mediated hypersensitivity to penicillins correlates well with subsequent clinical tolerance of therapeutic doses of carbapenems.

Original languageEnglish
Pages (from-to)1618-1621
Number of pages4
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume68
Issue number12
DOIs
Publication statusPublished - Dec 2013

Fingerprint

Carbapenems
Delayed Hypersensitivity
Penicillins
meropenem
T-Lymphocytes
Lactams
Hypersensitivity
Skin Tests
Immediate Hypersensitivity
Skin
Imipenem
Reading

Keywords

  • carbapenems
  • cross-reactivity
  • penicillin allergy
  • skin tests

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

Cite this

Absence of cross-reactivity to carbapenems in patients with delayed hypersensitivity to penicillins. / Romano, A.; Gaeta, F.; Valluzzi, R. L.; Alonzi, C.; Maggioletti, M.; Zaffiro, A.; Caruso, C.; Quaratino, D.

In: Allergy: European Journal of Allergy and Clinical Immunology, Vol. 68, No. 12, 12.2013, p. 1618-1621.

Research output: Contribution to journalArticle

Romano, A, Gaeta, F, Valluzzi, RL, Alonzi, C, Maggioletti, M, Zaffiro, A, Caruso, C & Quaratino, D 2013, 'Absence of cross-reactivity to carbapenems in patients with delayed hypersensitivity to penicillins', Allergy: European Journal of Allergy and Clinical Immunology, vol. 68, no. 12, pp. 1618-1621. https://doi.org/10.1111/all.12299
Romano, A. ; Gaeta, F. ; Valluzzi, R. L. ; Alonzi, C. ; Maggioletti, M. ; Zaffiro, A. ; Caruso, C. ; Quaratino, D. / Absence of cross-reactivity to carbapenems in patients with delayed hypersensitivity to penicillins. In: Allergy: European Journal of Allergy and Clinical Immunology. 2013 ; Vol. 68, No. 12. pp. 1618-1621.
@article{a7e88e2c81aa45439b8d21ede9bfa7d2,
title = "Absence of cross-reactivity to carbapenems in patients with delayed hypersensitivity to penicillins",
abstract = "Studies performed on subjects with IgE-mediated hypersensitivity to penicillins have demonstrated a 1{\%} rate of cross-reactivity between penicillins and both imipenem and meropenem, while a single study found a 5.5{\%} rate of cross-reactivity with imipenem/cilastatin in subjects with T-cell-mediated hypersensitivity to β-lactams, mostly penicillins. We studied 204 consecutive subjects with a well-demonstrated T-cell-mediated hypersensitivity to assess the cross-reactivity with carbapenems and the tolerability of such alternative β-lactams. All 204 subjects underwent skin tests with imipenem/cilastatin and meropenem; 130 of them were skin-tested also with ertapenem. Subjects with negative test results were challenged with these carbapenems. All subjects displayed negative skin tests to carbapenems and tolerated challenges. These data demonstrate the absence of clinically significant T-cell-mediated cross-reactivity between penicillins and carbapenems. Negative delayed-reading skin testing with carbapenems in individuals with documented T-cell-mediated hypersensitivity to penicillins correlates well with subsequent clinical tolerance of therapeutic doses of carbapenems.",
keywords = "carbapenems, cross-reactivity, penicillin allergy, skin tests",
author = "A. Romano and F. Gaeta and Valluzzi, {R. L.} and C. Alonzi and M. Maggioletti and A. Zaffiro and C. Caruso and D. Quaratino",
year = "2013",
month = "12",
doi = "10.1111/all.12299",
language = "English",
volume = "68",
pages = "1618--1621",
journal = "Allergy: European Journal of Allergy and Clinical Immunology",
issn = "0105-4538",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - Absence of cross-reactivity to carbapenems in patients with delayed hypersensitivity to penicillins

AU - Romano, A.

AU - Gaeta, F.

AU - Valluzzi, R. L.

AU - Alonzi, C.

AU - Maggioletti, M.

AU - Zaffiro, A.

AU - Caruso, C.

AU - Quaratino, D.

PY - 2013/12

Y1 - 2013/12

N2 - Studies performed on subjects with IgE-mediated hypersensitivity to penicillins have demonstrated a 1% rate of cross-reactivity between penicillins and both imipenem and meropenem, while a single study found a 5.5% rate of cross-reactivity with imipenem/cilastatin in subjects with T-cell-mediated hypersensitivity to β-lactams, mostly penicillins. We studied 204 consecutive subjects with a well-demonstrated T-cell-mediated hypersensitivity to assess the cross-reactivity with carbapenems and the tolerability of such alternative β-lactams. All 204 subjects underwent skin tests with imipenem/cilastatin and meropenem; 130 of them were skin-tested also with ertapenem. Subjects with negative test results were challenged with these carbapenems. All subjects displayed negative skin tests to carbapenems and tolerated challenges. These data demonstrate the absence of clinically significant T-cell-mediated cross-reactivity between penicillins and carbapenems. Negative delayed-reading skin testing with carbapenems in individuals with documented T-cell-mediated hypersensitivity to penicillins correlates well with subsequent clinical tolerance of therapeutic doses of carbapenems.

AB - Studies performed on subjects with IgE-mediated hypersensitivity to penicillins have demonstrated a 1% rate of cross-reactivity between penicillins and both imipenem and meropenem, while a single study found a 5.5% rate of cross-reactivity with imipenem/cilastatin in subjects with T-cell-mediated hypersensitivity to β-lactams, mostly penicillins. We studied 204 consecutive subjects with a well-demonstrated T-cell-mediated hypersensitivity to assess the cross-reactivity with carbapenems and the tolerability of such alternative β-lactams. All 204 subjects underwent skin tests with imipenem/cilastatin and meropenem; 130 of them were skin-tested also with ertapenem. Subjects with negative test results were challenged with these carbapenems. All subjects displayed negative skin tests to carbapenems and tolerated challenges. These data demonstrate the absence of clinically significant T-cell-mediated cross-reactivity between penicillins and carbapenems. Negative delayed-reading skin testing with carbapenems in individuals with documented T-cell-mediated hypersensitivity to penicillins correlates well with subsequent clinical tolerance of therapeutic doses of carbapenems.

KW - carbapenems

KW - cross-reactivity

KW - penicillin allergy

KW - skin tests

UR - http://www.scopus.com/inward/record.url?scp=84889589735&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84889589735&partnerID=8YFLogxK

U2 - 10.1111/all.12299

DO - 10.1111/all.12299

M3 - Article

C2 - 24180646

AN - SCOPUS:84889589735

VL - 68

SP - 1618

EP - 1621

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

SN - 0105-4538

IS - 12

ER -