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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) |
