![]() Limiting observation after cephalosporin to 1-10 d Limiting observation after penicillin to 1-10 d Penicillin followed by sulfonamide antibiotic NO ALE after both penicillin and second antibioticĪLE after penicillin but not after second antibioticĪLE after second antibiotic but not after penicillin For the comparison group, the “index” penicillin prescription was the first prescribed penicillin.Īllergic-like events are narrowly defined.ĪLE after both penicillin and second antibiotic Comparison subjects never had an allergic-like event within 30 days after any penicillin prescription. The first penicillin prescription followed by an allergic-like event was called the “index” penicillin prescription. The study group consisted of patients who had an allergic-like event within 30 days after a penicillin prescription. Two subgroups were compared to calculate the risk of an allergic-like event after a cephalosporin. ![]() This cohort was used for the primary analyses. The 60-day interval between the first penicillin and the subsequent cephalosporin prescription ensured that an event after the cephalosporin was not a late event associated with the earlier penicillin. Within that population, we identified patients who also received a cephalosporin prescription at least 60 days after a penicillin prescription. We identified all patients in the GPRD UTS database from 1987 to September 2001 who received a prescription for penicillin ( Figure 1). Methods Data Source: General Practice Research Database To better understand etiology, we compared our results with analyses replacing cephalosporin with sulfonamide antibiotics because there is no known structural or immunologic cross-reactivity between penicillin and sulfonamide antibiotics. To study the question of allergic cross-reactivity between penicillins and cephalosporins, we conducted a retrospective cohort study using the United Kingdom General Practice Research Database (GPRD), a database of electronic primary care medical records and prescriptions. ![]() Furthermore, avoidance of an antibiotic because of an allergy history may result in the selection of a less effective or more toxic antibiotic. With the increase in bacterial antimicrobial resistance, particularly multidrug resistance, therapeutic options are increasingly limited. A major component of this research is understanding the risk of cephalosporin hypersensitivity in patients with penicillin allergy. ![]()
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