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This review evaluates the available data on immunoglobulin E-mediated penicillin hypersensitivity and cross-reactivity with cephalosporin, carbapenem, and monobactam antibiotics. A MEDLINE search was conducted from 1950 to October 2013, and selected references from review articles were also evaluated. There is a wide variety in reported incidences of cross-reactivity between penicillins and cephalosporins or carbapenems, with early retrospective studies suggesting up to 41.7% and 47.4% cross-reactivity, respectively. Conversely, the use of monobactam antibiotics is frequently employed in the case of a penicillin allergy, as prescribers believe that there is no cross-reactivity between the 2 drug classes. More recent prospective studies suggest that the rates of cross-reactivity with cephalosporins and carbapenems are &lt;5% and &lt;1%, respectively. Similarities in penicillin and cephalosporin side chains may play a role in cross-reactivity between these classes. Cross-reactivity with monobactams is essentially negligible; however, there are some clinical data to support an interaction between ceftazidime and aztreonam, due to the similarity of their side chains. The data reviewed suggest that avoidance of other beta-lactams in patients with type 1 hypersensitivity to penicillins should be reconsidered.<\/jats:p>","DOI":"10.1177\/0897190014546109","type":"journal-article","created":{"date-parts":[[2014,8,15]],"date-time":"2014-08-15T02:22:01Z","timestamp":1408069321000},"page":"530-544","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":46,"title":["Beta-Lactam Hypersensitivity and Cross-Reactivity"],"prefix":"10.1177","volume":"27","author":[{"given":"Adrienne T.","family":"Terico","sequence":"first","affiliation":[{"name":"Post-Graduate Year 2 Infectious Diseases Pharmacotherapy Resident, Temple University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason C.","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Temple University School of Pharmacy, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,8,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.18.2819"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62782-2"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/510386"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-279"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.31.8.742"},{"key":"e_1_3_2_7_2","first-page":"1444","volume-title":"Clinical Aspects of Immunology","author":"Gell PGH","year":"1968","unstructured":"Gell PGH. 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