{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:29:01Z","timestamp":1790684941490,"version":"4.1.0"},"reference-count":52,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jaci-inpractice.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Allergy and Clinical Immunology: In Practice"],"published-print":{"date-parts":[[2021,4]]},"DOI":"10.1016\/j.jaip.2020.11.032","type":"journal-article","created":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T02:34:27Z","timestamp":1606444467000},"page":"1648-1657.e1","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":22,"title":["Evaluating Immediate Reactions to Cephalosporins: Time Is of the Essence"],"prefix":"10.1016","volume":"9","author":[{"given":"Antonino","family":"Romano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco Luigi","family":"Valluzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano","family":"Caruso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Zaffiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donato","family":"Quaratino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Gaeta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jaip.2020.11.032_bib1","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.jaci.2014.07.062","article-title":"Adverse reactions associated with oral and parenteral use of cephalosporins: a retrospective population-based analysis","volume":"135","author":"Macy","year":"2015","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib2","series-title":"Cephalosporin hypersensitivity: clinical manifestations and diagnosis","author":"Romano","year":"2019"},{"key":"10.1016\/j.jaip.2020.11.032_bib3","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1016\/j.jaip.2019.06.001","article-title":"Cephalosporin allergy: current understanding and future challenges","volume":"7","author":"Khan","year":"2019","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.jaip.2020.11.032_bib4","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/all.12350","article-title":"International Consensus on drug allergy","volume":"69","author":"Demoly","year":"2014","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib5","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.anai.2014.02.005","article-title":"Penicillin and cephalosporin allergy","volume":"112","author":"Pichichero","year":"2014","journal-title":"Ann Allergy Asthma Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib6","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1046\/j.1365-2222.1999.00575.x","article-title":"Penicillins and cephalosporins as allergens--structural aspects of recognition and cross-reactions","volume":"29","author":"Baldo","year":"1999","journal-title":"Clin Exp Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib7","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1067\/mai.2000.111147","article-title":"Immediate allergic reactions to cephalosporins: cross-reactivity and selective responses","volume":"106","author":"Romano","year":"2000","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib8","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1002\/jmr.621","article-title":"Synthesis, characterization and immunochemical evaluation of cephalosporin antigenic determinants","volume":"16","author":"S\u00e1nchez-Sancho","year":"2003","journal-title":"J\u00a0Mol Recognit"},{"key":"10.1016\/j.jaip.2020.11.032_bib9","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1111\/j.1365-2222.2005.02317.x","article-title":"Diagnosing immediate reactions to cephalosporins","volume":"35","author":"Romano","year":"2005","journal-title":"Clin Exp Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib10","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.jaci.2005.10.032","article-title":"Immediate allergic reactions to cephalosporins: evaluation of cross-reactivity with a panel of penicillins and cephalosporins","volume":"117","author":"Antunez","year":"2006","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib11","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1542\/peds.2007-3178","article-title":"Diagnosing hypersensitivity reactions to cephalosporins in children","volume":"122","author":"Romano","year":"2008","journal-title":"Pediatrics"},{"key":"10.1016\/j.jaip.2020.11.032_bib12","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1016\/j.jaci.2010.06.052","article-title":"IgE-mediated hypersensitivity to cephalosporins: cross-reactivity and tolerability of penicillins, monobactams, and carbapenems","volume":"126","author":"Romano","year":"2010","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib13","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/j.jaci.2015.03.012","article-title":"IgE-mediated hypersensitivity to cephalosporins: cross-reactivity and tolerability of alternative cephalosporins","volume":"136","author":"Romano","year":"2015","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib14","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s11882-016-0594-9","article-title":"Cross-reactivity among beta-lactams","volume":"16","author":"Romano","year":"2016","journal-title":"Curr Allergy Asthma Rep"},{"key":"10.1016\/j.jaip.2020.11.032_bib15","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jaip.2017.08.027","article-title":"Cross-reactivity in \u03b2-lactam allergy","volume":"6","author":"Zagursky","year":"2018","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.jaip.2020.11.032_bib16","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1034\/j.1398-9995.2003.00280.x","article-title":"Diagnosis of immediate allergic reactions to beta-lactam antibiotics","volume":"58","author":"Torres","year":"2003","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib17","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1111\/j.1398-9995.2008.01924.x","article-title":"Update on the evaluation of hypersensitivity reactions to betalactams","volume":"64","author":"Blanca","year":"2009","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib18","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1111\/cea.12468","article-title":"Management of allergy to penicillins and other beta-lactams","volume":"45","author":"Mirakian","year":"2015","journal-title":"Clin Exp Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib19","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1111\/all.14122","article-title":"Towards a more precise diagnosis of hypersensitivity to beta-lactams \u2013 an EAACI position paper","volume":"75","author":"Romano","year":"2020","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib20","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1159\/000495302","article-title":"The diagnosis of ceftriaxone hypersensitivity in a paediatric population","volume":"178","author":"Mori","year":"2019","journal-title":"Int Arch Allergy Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib21","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1111\/all.12142","article-title":"Skin test concentrations for systemically administered drugs -- an ENDA\/EAACI Drug Allergy Interest Group position paper","volume":"68","author":"Brockow","year":"2013","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib22","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0091-6749(03)01783-4","article-title":"Nonirritating intradermal skin test concentrations for commonly prescribed antibiotics","volume":"112","author":"Empedrad","year":"2003","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib23","first-page":"171","article-title":"Nonirritating concentration for skin testing with cephalosporins","volume":"20","author":"Testi","year":"2010","journal-title":"J\u00a0Investig Allergol Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib24","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1111\/all.12886","article-title":"In\u00a0vitro tests for drug hypersensitivity reactions: an ENDA\/EAACI Drug Allergy Interest Group position paper","volume":"71","author":"Mayorga","year":"2016","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib25","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/S0091-6749(99)70439-2","article-title":"Natural evolution of skin test sensitivity in patients allergic to beta-lactam antibiotics","volume":"103","author":"Blanca","year":"1999","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib26","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1111\/all.12390","article-title":"Natural evolution of skin-test sensitivity in patients with IgE-mediated hypersensitivity to cephalosporins","volume":"69","author":"Romano","year":"2014","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib27","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S0022-3476(98)70499-8","article-title":"Diagnosis of penicillin, amoxicillin, and cephalosporin allergy: reliability of examination assessed by skin testing and oral challenge","volume":"132","author":"Pichichero","year":"1998","journal-title":"J\u00a0Pediatr"},{"key":"10.1016\/j.jaip.2020.11.032_bib28","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1111\/all.13032","article-title":"Performance in real life of the European Network on Drug Allergy algorithm in immediate reactions to beta-lactam antibiotics","volume":"71","author":"Moreno","year":"2016","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib29","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.jaci.2005.12.1303","article-title":"Second symposium on the definition and management of anaphylaxis: summary report\u2014Second National Institute of Allergy and Infectious Disease\/Food Allergy and Anaphylaxis Network symposium","volume":"117","author":"Sampson","year":"2006","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib30","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.jaci.2004.04.029","article-title":"Clinical features and severity grading of anaphylaxis","volume":"114","author":"Brown","year":"2004","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib31","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/j.jaci.2014.10.011","article-title":"Tolerability of aztreonam and carbapenems in patients with IgE-mediated hypersensitivity to penicillins","volume":"135","author":"Gaeta","year":"2015","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib32","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1046\/j.0105-4538.2001.00001.x-i8","article-title":"General considerations for skin test procedures in the diagnosis of drug hypersensitivity","volume":"57","author":"Brockow","year":"2002","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib33","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jaci.2016.01.025","article-title":"Cross-reactivity and tolerability of aztreonam and cephalosporins in subjects with a T cell-mediated hypersensitivity to penicillins","volume":"138","author":"Romano","year":"2016","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib34","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1016\/j.jaip.2016.05.011","article-title":"Cefazolin hypersensitivity: toward optimized diagnosis","volume":"4","author":"Uyttebroek","year":"2016","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.jaip.2020.11.032_bib35","series-title":"The Medicines Utilisation Monitoring Centre. National report on medicines use in Italy. 2018","year":"2019"},{"key":"10.1016\/j.jaip.2020.11.032_bib36","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1111\/all.12182","article-title":"Validation of the cephalosporin intradermal skin test for predicting immediate hypersensitivity: a prospective study with drug challenge","volume":"68","author":"Yoon","year":"2013","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib37","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1034\/j.1398-9995.57.s72.18.x","article-title":"Immediate hypersensitivity to cephalosporins","volume":"57","author":"Romano","year":"2002","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib38","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1111\/cea.12455","article-title":"Clinical and diagnostic features of perioperative hypersensitivity to cefuroxime","volume":"45","author":"Christiansen","year":"2015","journal-title":"Clin Exp Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib39","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/j.1398-9995.1994.tb00809.x","article-title":"Allergic reactions to betalactams: studies in a group of patients allergic to penicillin and evaluation of cross-reactivity with cephalosporin","volume":"49","author":"Audicana","year":"1994","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib40","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1046\/j.1365-2222.2001.00992.x","article-title":"Lack of allergic cross-reactivity to cephalosporins among patients allergic to penicillins","volume":"31","author":"Novalbos","year":"2001","journal-title":"Clin Exp Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib41","doi-asserted-by":"crossref","first-page":"16","DOI":"10.7326\/0003-4819-141-1-200407060-00010","article-title":"Cross-reactivity and tolerability of cephalosporins in patients with immediate hypersensitivity to penicillins","volume":"141","author":"Romano","year":"2004","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.jaip.2020.11.032_bib42","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1159\/000301579","article-title":"Safety of cefuroxime as an alternative in patients with a proven hypersensitivity to penicillins: a DAHD cohort survey","volume":"153","author":"Caimmi","year":"2010","journal-title":"Int Arch Allergy Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib43","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1016\/j.jaip.2018.01.020","article-title":"Cross-reactivity and tolerability of cephalosporins in patients with IgE-mediated hypersensitivity to penicillins","volume":"6","author":"Romano","year":"2018","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.jaip.2020.11.032_bib44","first-page":"27","article-title":"Drug allergy evaluation for betalactam hypersensitivity: cross-reactivity with cephalosporines, carbapenems and negative predictive value","volume":"36","author":"Al-Ahmad","year":"2018","journal-title":"Asian Pac J Allergy Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib45","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1016\/j.jaip.2020.02.025","article-title":"Tolerability of cefazolin and ceftibuten in patients with IgE-mediated aminopenicillin allergy","volume":"8","author":"Romano","year":"2020","journal-title":"J\u00a0Allergy Clin Immunol Pract"},{"key":"10.1016\/j.jaip.2020.11.032_bib46","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1093\/bja\/aew274","article-title":"Cefalotin as antimicrobial prophylaxis in patients with known intraoperative anaphylaxis to cefazolin","volume":"117","author":"Sadleir","year":"2016","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.jaip.2020.11.032_bib47","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1111\/all.13435","article-title":"Incidence of cephalosporin-induced anaphylaxis and clinical efficacy of screening intradermal tests with cephalosporins: a large multicentre retrospective cohort study","volume":"73","author":"Yang","year":"2018","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib48","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1016\/j.jaci.2019.11.036","article-title":"Design of an antigenic determinant of cefaclor: chemical structure-IgE recognition relationship","volume":"145","author":"Mart\u00edn-Serrano","year":"2020","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.jaip.2020.11.032_bib49","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1111\/j.1398-9995.2006.01120.x","article-title":"IgE antibodies to betalactams: relationship between the triggering hapten and the specificity of the immune response","volume":"61","author":"Ant\u00fanez","year":"2006","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2020.11.032_bib50","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1084\/jem.124.3.331","article-title":"Disquisitions of original antigenic sin, I: evidence in man","volume":"124","author":"Webster","year":"1966","journal-title":"J\u00a0Exp Med"},{"key":"10.1016\/j.jaip.2020.11.032_bib51","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1542\/peds.2004-1276","article-title":"A\u00a0review of evidence supporting the American Academy of Pediatrics recommendation for prescribing cephalosporin antibiotics for penicillin allergic patients","volume":"115","author":"Pichichero","year":"2005","journal-title":"Pediatrics"},{"key":"10.1016\/j.jaip.2020.11.032_bib52","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1111\/imj.14229","article-title":"Immediate cephalosporin allergy","volume":"49","author":"Yuson","year":"2019","journal-title":"Intern Med J"}],"container-title":["The Journal of Allergy and Clinical Immunology: In Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213219820312538?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213219820312538?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T05:26:40Z","timestamp":1761974800000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2213219820312538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":52,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["S2213219820312538"],"URL":"https:\/\/doi.org\/10.1016\/j.jaip.2020.11.032","relation":{},"ISSN":["2213-2198"],"issn-type":[{"value":"2213-2198","type":"print"}],"subject":[],"published":{"date-parts":[[2021,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Evaluating Immediate Reactions to Cephalosporins: Time Is of the Essence","name":"articletitle","label":"Article Title"},{"value":"The Journal of Allergy and Clinical Immunology: In Practice","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jaip.2020.11.032","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 American Academy of Allergy, Asthma & Immunology","name":"copyright","label":"Copyright"}]}}