{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:07:59Z","timestamp":1791446879503,"version":"4.3.3"},"reference-count":128,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,4,1]]},"abstract":"<jats:p>The American Academy of Pediatrics, evidence-based guidelines endorse the use of cephalosporin antibiotics for patients with reported allergies to penicillin, for the treatment of acute bacterial sinusitis and acute otitis media. Many physicians, however, remain reluctant to prescribe such agents. Although such concern is understandable, lack of consistent data regarding exactly what constitutes an initial penicillin-allergic reaction and subsequent cross-sensitivity to cephalosporins may be preventing many patients from receiving optimal antibiotic therapy. This article reviews evidence in support of the American Academy of Pediatrics recommendation. Included is an examination of the types and incidence of reactions to penicillins and cephalosporins; the frequency of cross-reactivity between these 2 groups of agents; experimental and clinical studies that suggest that side chain-specific antibodies predominate in the immune response to cephalosporins, thereby explaining the lack of cross-sensitivity between most cephalosporins and penicillins; the role of skin testing; and the risks of anaphylaxis. Specific recommendations for the treatment of patients on the basis of their responses to previously prescribed agents are summarized.<\/jats:p>","DOI":"10.1542\/peds.2004-1276","type":"journal-article","created":{"date-parts":[[2005,4,1]],"date-time":"2005-04-01T18:03:40Z","timestamp":1112378620000},"page":"1048-1057","source":"Crossref","is-referenced-by-count":182,"title":["A Review of Evidence Supporting the American Academy of Pediatrics Recommendation for Prescribing Cephalosporin Antibiotics for Penicillin-Allergic Patients"],"prefix":"10.1542","volume":"115","author":[{"given":"Michael E.","family":"Pichichero","sequence":"first","affiliation":[{"name":"From the University of Rochester, Elmwood Pediatric Group, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2005,4,1]]},"reference":[{"key":"2021120819300114500_R1","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Subcommittee on Management of Sinusitis and Committee on Quality Improvement. 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Immediate hypersensitivity reactions to \u03b2-lactam antibiotics. Ann Intern Med.\u20081987;107:204\u2013215","DOI":"10.7326\/0003-4819-107-2-204"},{"key":"2021120819300114500_R6","doi-asserted-by":"crossref","unstructured":"Levine BB, Fellner MJ, Levytska V, Franklin EC, Alisburg N. Benzylpenicilloyl-specific serum antibodies to penicillin in man. II. Sensitivity of the hemagglutination assay method, molecular classes of the antibodies detected, and antibody titers of randomly selected patients. J Immunol.\u20081966;96:719\u2013726","DOI":"10.4049\/jimmunol.96.4.719"},{"key":"2021120819300114500_R7","unstructured":"Assem ESK, Vickers MR. Tests for penicillin allergy in man: the immunological cross-reaction between penicillins and cephalosporins. Immunology.\u20081974;27:255\u2013269"},{"key":"2021120819300114500_R8","unstructured":"Batchelor FR, Dewdney JM, Weston RD, Wheeler AW. The immunogenicity of cephalosporin derivatives and their cross-reaction with penicillin. 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