Das Kreuz mit der Kreuzallergie: Betalaktamantibiotika-Allergie

Abstract

Hypersensitivity reactions to betalactam antibiotics are the most commonly mentioned drug allergies. Up to 10 percent of patients report to suffer from a penicillin allergy. However, classical side effects of antibiotics are often misdiagnosed as an allergy. Many of these patients with suspected betalactam allergy tolerate betalactam antibiotics well. Therefore, a thorough allergy workup is essential to confirm a suspected allergy or to enable again a treatment with betalactam antibiotics. Most important is a good documentation as skin- and in-vitro tests have a reduced sensitivity. Gold standard is the provocation test to help exclude a supposed allergy or to test alternative, potential cross reactive betalactam antibiotics. Cross-reactions between penicillins and cephalosporins, especially cephalosporins of the third and fourth generation are unusual. Cross reactions to carbapenem antibiotics are rare.