What is the risk of using a cephalosporin in a patient with a penicillin allergy?
A Cormier, MJ Rieder, D Matsui A 10-year-old boy in your practice has an allergy to penicillin, which his mother describes as hives. He has now developed an acute bacterial sinusitis that you wish to treat with antibiotics. He is otherwise healthy. You wonder about the risk of using a cephalosporin in an individual with a penicillin allergy. DISCUSSION Historically, the classic recommendation for management of an individual with a penicillin allergy has been to avoid the use of cephalosporins. This recommendation was primarily based on the widespread belief that there was approximately 10% cross-reactivity between penicillins and cephalosporins, prompting cautionary statements to be placed on penicillin and cephalosporin pharmaceutical labels (1).
