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Cross-Allergenicity of the Penicillins and the Cephalosporins

Michael H. Grieco, MD
Arch Intern Med. 1967;119(2):141-146. doi:10.1001/archinte.1967.00290200065002.
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Allergic reactions to penicillin occur in approximately 1% to 10% of patients.1 The frequency of anaphylaxis, the most severe type of reaction, is also variable but one recent study revealed nonfatal anaphylaxis in 0.11% of cases of which 0.035% were considered severe.2 From Welch's study in 1957, it is estimated that 10% of severe penicillin anaphylactic reactions are fatal.3

The problem of penicillin hypersensitivity has been approached in two separate ways. First, an intensive effort has been made to define an objective and dependable method for detecting penicillin allergy. Multiple studies have been published dealing with the use of penicillin and several metabolites in an attempt to demonstrate skin-sensitizing antibody,4,5 hemagglutinating antibody,6,7 indirect basophil degranulation,8 histamine release from leukocytes,9 rabbit passive cutaneous anaphylaxis,10 and increase of lymphocyte size with tissue culture of sensitized lymphocytes.11 A well-defined testing procedure has not yet been evolved.1

Since all penicillin derivations, including penicillin O,


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