{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T00:42:41Z","timestamp":1759624961570,"version":"build-2065373602"},"reference-count":3,"publisher":"Colegio Mexicano de Inmunologia Clinica y Alergia, A. C.","issue":"3","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["revistaalergia.mx"],"crossmark-restriction":false},"short-container-title":["Rev. Alergia Mex"],"published-print":{"date-parts":[[2025,9,30]]},"abstract":"<jats:p>Background: Cephalosporin-induced anaphylaxis is uncommon (6.1\/10,000 exposures), and the diagnosis in pediatrics entails challenges due to nonspecific clinical histories and lack of standardized diagnostic tests. G-Penicillin has demonstrated diagnostic utility in the absence of penicilloilpolylisin, with a negative predictive value up to 95.2% when combined with controlled oral challenge. The basophil activation test (BAT) has a variable sensitivity (38\u201375%), depending on the assessed biomarker.\n\nCase report: A 13-year-old male presented anaphylaxis two minutes after receiving intramuscular ceftriaxone. He presented with pharyngeal pruritus, facial angioedema, dyspnea, vomiting, and altered alertness. The condition resolved with intramuscular adrenaline and intravenous crystalloid administration. Test results: BAT for ceftriaxone and cefuroxime were negative. Skin tests were negative for penicillin and cefuroxime and positive for ceftriaxone. Outcome: Oral challenge with amoxicillin was tolerated. The use of ceftriaxone and cephalosporins with an identical R1 side chain were contraindicated.\n\nConclusions: When dealing with a patient with drug allergy, clinicians should implement diagnostic tools that include skin testing with specific antibiotics and oral challenge. It is important to reconsider unconfirmed allergy labels, as it is estimated that between 58% and 75% of pediatric patients diagnosed with \u201ccephalosporin allergy\u201d present low-risk symptoms and could be delabeled with appropriate protocols. Cephalosporin anaphylaxis requires a combined evaluation. Penicillin G skin testing and oral challenge are key tools to guide safe antibiotic treatment.\n\nKeywords: Drug allergy; Beta-lactams; Skin testing; Basophil activation test.<\/jats:p>","DOI":"10.29262\/ram.v72i3.1492","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T14:16:56Z","timestamp":1759241816000},"page":"217-217","update-policy":"https:\/\/doi.org\/10.29262\/ram.crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Ceftriaxone-Induced Anaphylaxis in a Pediatric Patient: Challenges and Management"],"prefix":"10.29262","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4603-6948","authenticated-orcid":false,"given":"Mar\u00eda Rosina","family":"L\u00f3pez Forte","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"11808","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"62521","doi-asserted-by":"crossref","unstructured":"1. Chow TG, Brunner ES, Khan DA. Cephalosporin Allergy: Updates on Diagnostic Testing. Curr Allergy Asthma Rep.2024;24(8):581\u2013590. https:\/\/doi.org\/10.1007\/s11882-024-01171-9","DOI":"10.1007\/s11882-024-01171-9"},{"key":"62522","doi-asserted-by":"crossref","unstructured":"2. Picard M, Paradis L, B\u00e9gin P, Paradis J, Des Roches A. Skin testing only with penicillin G in children with a history of penicillin allergy. Ann Allergy Asthma Immunol. 2014;113(1):75\u201381. https:\/\/doi.org\/10.1016\/j.anai.2014.04.017","DOI":"10.1016\/j.anai.2014.04.017"},{"key":"62523","doi-asserted-by":"crossref","unstructured":"3. Zembles T, Zhan Y, Chiu A, Brousseau DC, Vyles D. Cephalosporin allergy symptoms in children presenting to a pediatric emergency department. Ann Allergy Asthma Immunol. 2021;127(3):257\u2013277. https:\/\/doi.org\/10.1016\/j.anai.2021.04.022","DOI":"10.1016\/j.anai.2021.04.022"}],"container-title":["Revista Alergia M\u00e9xico"],"original-title":["Anafilaxia a ceftriaxona en paciente pedi\u00e1trico: Desaf\u00edos y manejo"],"link":[{"URL":"https:\/\/revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1492\/2754","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/revistaalergia.mx\/ojs\/index.php\/ram\/article\/download\/1492\/2754","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T15:43:33Z","timestamp":1759592613000},"score":1,"resource":{"primary":{"URL":"https:\/\/revistaalergia.mx\/ojs\/index.php\/ram\/article\/view\/1492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":3,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9,30]]},"published-print":{"date-parts":[[2025,9,30]]}},"URL":"https:\/\/doi.org\/10.29262\/ram.v72i3.1492","relation":{},"ISSN":["0002-5151","2448-9190"],"issn-type":[{"type":"print","value":"0002-5151"},{"type":"electronic","value":"2448-9190"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}