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Table 8.3 Risk of cross-reactivity between different ß-lactams

Allergic to Drug of concern Risk of cross-reactivity
Cephalosporin Penicillin 8.3%–25.5% in two series (515–516)
*Cephalosporins with structures similar or identical to penicillin have 3-fold increase in risk
Carbapenems Imipenem 2% and meropenem 1% in one series
Penicillin Cephalosporins 10.9% with most involving cephalothin and cefamandole (517)
Carbapenems Meropenem 0.9%, imipenem 0.9% (518–520)
All first generation cephalosporins Odds ratio: first generation cephalosporins 4.2, second generation cephalosporins 1.1 and third generation cephalosporins 0.8 (521)
Cephalexin 31% in one series with 16 patients (522)
Amoxicillin Cefadroxil 38% (cefadroxil has identical side chain to amoxicillin) (523)
Cefamandole 0% for 21 patients (different side chain to amoxicillin) (523)