Allergy to cloxacillin with normal tolerance to amoxicillin and cefuroxime.

Abstract:

BACKGROUND:Cloxacillin is a semisynthetic penicillin widely used in nonmethicillin resistant Staphylococcus aureus infections. Several hypersensitivity reactions to cloxacillin have been reported, although IgE-mediated allergic reactions to the drug are rare and there is little information about possible tolerance to other semisynthetic penicillins or cephalosporins in patients with cloxacillin allergy. We present 2 patients with demonstrated IgE-mediated allergy to cloxacillin and tolerance to amoxicillin and cefuroxime. CASE REPORTS:Case 1. A 47-year-old woman began treatment with cloxacillin due to acute cellulitis. After ingesting 500 mg of the drug, she experience generalized maculopapular eruption and facial angioedema. Case 2. A 55-year-old woman presented an episode of acute urticaria and labial angioedema 60 minutes after ingesting 500 mg of cloxacillin for a skin abscess. METHODS AND RESULTS:Skin prick tests were positive to cloxacillin in case 1 and negative in case 2. However, an intradermal test was positive to cloxacillin (2 mg/ml) in case 2. Simple-blind oral challenge tests with amoxicillin (1 g) and cefuroxime (500 mg) were well-tolerated by both patients. CONCLUSIONS:We present 2 patients allergic to cloxacillin with normal tolerance to other betalactam antibiotics, confirming that cross-reactivity among these antibiotics seems to be uncommon. Complete allergy study, including an oral challenge test, should be considered in these patients.

authors

Domínguez-Ortega J,Martínez-Alonso JC,Marcos-Pérez MC,Kindelan C,Frades A

doi

10.1157/13084226

keywords:

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

37-8

issue

1

eissn

0301-0546

issn

1578-1267

pii

13084226

journal_volume

34

pub_type

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