{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:34:27Z","timestamp":1791200067548,"version":"4.2.0"},"reference-count":47,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T00:00:00Z","timestamp":1463443200000},"content-version":"vor","delay-in-days":3365,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Recent analysis of clinical data and a clearer understanding of the role of chemical structure in the development of cross\u2010reactivity indicate that the increased risk of an allergic reaction to a cephalosporin in penicillin\u2010allergic patients is smaller than previously postulated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Medline and EMBASE databases were searched with the keywords: cephalosporin, penicillin, allergy, and crosssensitivity for the years 1960 through 2005. Among 219 articles retrieved, 9 served as source material for this evidence\u2010based meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A significant increase in allergic reactions to cephalothin (odds ratio [OR] = 2.5; 95% confidence interval [CI] = 1.1 to 5.5), cephaloridine (OR = 8.7; CI = 5.9 to 12.8), and cephalexin (OR = 5.8; CI = 3.6 to 9.2), and all first generation cephalosporins plus cefamandole (OR = 4.8; CI = 3.7 to 6.2) were observed in penicillin allergic patients; no increase was observed with second generation cephalosporins (OR = 1.1; CI, 0.6 to 2.1) or third generation cephalosporins (OR = 0.5; CI = 0.2 to 1.1). Clinical challenges, skin testing, and monoclonal antibody studies point to the paramount importance of similarities in side chain structure to predict cross\u2010allergy between cephalosporins and penicillins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>First\u2010generation cephalosporins have cross\u2010allergy with penicillins, but cross\u2010allergy is negligible with second\u2010and third\u2010generation cephalosporins. Particular emphasis should be placed on the role of chemical structure in determining the risk of cross\u2010reactivity between specific agents.<\/jats:p><jats:p>2007 American Academy of Otolaryngology\u2010Head and Neck Surgery Foundation. All rights reserved.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2006.10.007","type":"journal-article","created":{"date-parts":[[2007,2,26]],"date-time":"2007-02-26T10:43:42Z","timestamp":1172486622000},"page":"340-347","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":152,"title":["Safe use of selected cephalosporins in penicillin\u2010allergic patients: A meta\u2010analysis"],"prefix":"10.1002","volume":"136","author":[{"given":"Michael E.","family":"Pichichero","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology University of Rochester Elmwood Pediatric Group, Otolaryngology, Head and Neck Surgery University of Rochester Medical Center Rochester NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet R.","family":"Casey","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology University of Rochester Elmwood Pediatric Group, Otolaryngology, Head and Neck Surgery University of Rochester Medical Center Rochester NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.5.1451"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.108.3.798"},{"issue":"1","key":"e_1_2_6_4_1","first-page":"1","article-title":"Antimicrobial treatment guidelines for acute bacterial rhinosinusitis.","volume":"130","author":"Anon JB","year":"2004","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1276"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/1.suppl_3.107"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/137.Supplement.S74"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1964.03070110025005"},{"key":"e_1_2_6_10_1","first-page":"247","article-title":"Cephalothin: laboratory and clinical studies in 109 patients","volume":"161","author":"Walters EW","year":"1963","journal-title":"Antimicrobial Agents Chemother"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1992.00400170020005"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(82)90105-1"},{"key":"e_1_2_6_13_1","first-page":"262","article-title":"Administration of cephalosporin antibiotics to patients with a history of penicillin allergy [abstract]","volume":"91","author":"Shepherd G","year":"1993","journal-title":"J Allergy Clin Immunol"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.198.4.345"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0300-483X(94)02983-2"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000235291"},{"issue":"2","key":"e_1_2_6_17_1","first-page":"255","article-title":"Tests for penicillin allergy in man. 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