{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:35:00Z","timestamp":1791200100703,"version":"4.2.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2009,2,1]],"date-time":"2009-02-01T00:00:00Z","timestamp":1233446400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2009,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the literature on the allergic cross-reactivity between penicillin, carbapenem, and monobactam antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>A MEDLINE search (1950\u2013June 2008) of the English literature was performed using the search terms \u03b2-lactam, penicillin, monobactam, carbapenem, allergy, and cross-reactivity. References of review articles were also screened for inclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection and Data Extraction:<\/jats:title>\n                    <jats:p>All articles in English from the data source were identified. Studies whose primary goal was to evaluate drug hypersensitivity and the potential for cross-reactivity were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis:<\/jats:title>\n                    <jats:p>Many patients have reported penicillin allergies that have not been verified by skin testing; many healthcare providers avoid the use of other \u03b2-lactam antibiotics, namely carbapenems, in these patients due to fear of the potential for immunoglobulin E-mediated allergic cross-reactivity. A wide range of cross-reactivity between penicillins and carbapenems has been reported in various studies; however, more recent prospective studies have shown the incidence of cross-reactivity between penicillin and carbapenem skin tests to be around 1%. Additionally, many prescribers freely use the monobactam aztreonam in penicillin-allergic patients, believing there is no cross-reactivity between the 2 drugs. Although data support the lack of cross-reactivity between aztreonam and penicillins, immunology and some clinical data support an interaction between ceftazidime and aztreonam due to the similarity of their side chains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Although variability in cross-reactivity rates between \u03b2-lactam classes exists in the literature, the practice of avoiding carbapenems in penicillin-allergic patients should be reconsidered. With regard to monobactams, the administration of aztreonam in a patient with a ceftazidime allergy may carry an increased risk of type 1 hypersensitivity reactions and should be considered with caution. Additionally, the importance of obtaining a thorough patient history regarding the previous allergic event, proper documentation, and penicillin skin testing is re emphasized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1l486","type":"journal-article","created":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T23:04:00Z","timestamp":1233702240000},"page":"304-315","source":"Crossref","is-referenced-by-count":75,"title":["Allergic Cross-Sensitivity Between Penicillin, Carbapenem, and Monobactam Antibiotics: What are the Chances?"],"prefix":"10.1177","volume":"43","author":[{"given":"Jane","family":"Frumin","sequence":"first","affiliation":[{"name":"Internal Medicine Pharmacy Resident, Clinical Instructor, Department of Pharmacy Services, MCV Campus, School of Pharmacy, Virginia Commonwealth University, Richmond, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason C","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Clinical Assistant Professor, Clinical Specialist, Infectious Diseases, School of Pharmacy, Temple University, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2009,2,3]]},"reference":[{"key":"bibr1-aph.1L486","first-page":"S483","volume":"115","year":"2005","journal-title":"The diagnosis and management of anaphylaxis: an updated practice parameter. 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