RT Journal Article
T1 Diagnostic Approach of Hypersensitivity Reactions to Cefazolin in a Large Prospective Cohort.
A1 Bogas Herrera, Gádor
A1 Doña, Inmaculada
A1 Dionicio, Javier
A1 Fernández-Duarte, Tahía Diana
A1 Mayorga Mayorga, Cristobalina
A1 Boteanu, Cosmin
A1 Montañez-Vega, María Isabel
A1 Rondón, Carmen
A1 Moreno, Esther
A1 Laguna, José J.
A1 Torres-Jaén, María Josefa
K1 Cefazolina
K1 Anafilaxia
K1 Medicamentos - Efectos secundarios
K1 Alergia a los medicamentos
K1 Diagnóstico
K1 Antibióticos - Ensayos clínicos
AB Introduction: Cefazolin is a common trigger of perioperative anaphylaxis. The diagnostic approach is controversial as the optimal concentration for skin testing is uncertain, drug provocation tests (DPTs) are contraindicated in severe reactions, and in vitro tests are not thoroughly validated. We aimed to characterise a large number of patients reporting cefazolin allergic reactions, and to analyse in vivo and in vitro tests’ diagnostic role.Methods: We prospectively evaluated patients with suspicion of allergic reactions to cefazolin by clinical history, skin tests (STs), and, if negative, DPT. In a subgroup of patients (both allergic and non-allergic), basophil activation test (BAT) and radioallergosorbent test (RAST) were also done.Results: From 184 evaluated patients, 41.3% were confirmed as allergic, 48.9% as non-allergic, and in 9.8% diagnosis was not confirmed. All reactions were immediate, besides, all cases reporting anaphylactic shock and most patients reporting anaphylaxis were confirmed as allergic (p<0.001); 52.6% of allergic cases were confirmed by STs, 28.9% by DPT, and 18.4% by clinical history. All subjects manifesting exanthemas and generalised pruritus were non-allergic. BAT sensitivity was 66.7% when combining CD63 and CD203c as activation markers. Six out of eight patients with negative STs and positive DPT had a positive BAT. Conclusions: Allergic patients to cefazolin often reported severe immediate-type reactions. STs allowed diagnosing half of patients. Unfortunately, DPT could not be performed in all cases due to reaction severity, being BAT a promising diagnostic tool. Further researches are needed to clarify the underlying mechanisms, especially in patients with severe reactions.
PB Elsevier
YR 2021
FD 2021
LK https://hdl.handle.net/10630/39756
UL https://hdl.handle.net/10630/39756
LA eng
NO The journal of allergy and clinical immunology. In practice 2021;9(12):4421-30 e4
NO *Bogas G and Doña I should be considered joint first author.*Moreno E, Laguna JJ and Torres MJ should be considered joint senior author.
NO https://www.elsevier.com/about/policies-and-standards/sharing#2-preprint: "Authors can share their preprint anywhere at any time."
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 20 ene 2026