Cross-reactivity between other beta lactams

In patients with penicillin allergy confirmed on testing, the rate of immune-mediated cross-reactivity with carbapenems (eg ertapenem, imipenem, meropenem) is approximately 1%. There is no cross-reactivity between penicillins and monobactams (eg aztreonam).

Note:

Cross-reactivity between penicillins and carbapenems is approximately 1%.

There is no cross-reactivity between penicillins and monobactams.

Data are lacking to inform the management of patients with cephalosporin allergy. Examples of beta-lactam antibiotics with R1 side-chain similarity contains a list of beta lactams that share the same or similar R1 side-chains and so are more likely to cross-react. Antimicrobials to avoid based on potential cross-reactivity due to identical or similar R1 side-chains are:

  • ceftriaxone allergy – avoid cefotaxime, cefepime and cefuroxime
  • ceftazidime allergy – avoid aztreonamRomano 2016.