Safety of Cefazolin in Prophylaxis in Β-Lactam Allergic Children

Abstract

Objective:Cefazolin is a first-generation cephalosporin, particularly effective against gram positive agents such as staphylococci and streptococci. Despite this narrow spectrum, it is important in surgical prophylaxis. In this study, we aimed to evaluate the tolerability of cefazolin in patients with confirmed β-lactam allergy.Methods:Patients who underwent cefazolin allergic work-up due to suspected cefazolin allergy (Group 1) and children with confirmed β-lactam allergy other than cefazolin (Group 2) were included in the study as two groups. β-lactam allergy was confirmed by determining positivity of skin test and/or provocation test with culprit drug and penicillin. Cefazolin skin test was performed in all patients. The provocation test was also applied to all patients with negative skin tests.Results:A total of 35 patients were evaluated. Eleven of them had a history of suspected allergic reactions after using cefazolin. The remaining 24 had a confirmed β-lactam allergy. Cefazolin allergy was confirmed in 3 patients. We confirmed cefazolin allergy in 1 of 11 children with suspected reactions. Two of the patients with confirmed β-lactam allergy had also cefazolin allergy and both of them had allergy to more than one β-lactam antibiotics.Conclusion:The majority of patients with a β-lactam allergy can tolerate cefazolin. Our findings imply that children with confirmed allergy to more than β-lactam antibiotics and peniclillin are also sensitive to cefazolin. Children with selective cefazolin allergy are expected to be sensitive to the side chain. A detailed history and comprehensive allergic evaluation are crucial in deciding the use of cefazolin in β-lactam-allergic patients.

Keywords

• drug allergy
• beta-lactams
• cross reaction
• cefazolin