Monobactams (aztr
eonam)
Carba
penems
Treatment
Table 4. Groups of β-Lactam Antibiotics That Share Identical R1
Amoxicillin Ampicillin Cefadroxil Cefaclor Cefprozil Cephalexin Cefatrizine Cephradine
-Group Side Chainsa Ceſtriaxone
Cefoxitin Cefamandole Ceſtazidime
Cefotaxime Cephaloridine Cefonicid Aztreonam Cefpodoxime Cephalothin Cefditoren
Cephaloglycin Ceſtizoxime Loracarbef
Cefmenoxime a Each column represents a group with identical R1 side chains.
Table 5. Groups of β-Lactam Antibiotics That Share Identical R2
-Group Side Chainsa Cephalexin Cefotaxime Cefuroxime Cefotetan
Cefadroxil Cephalothin Cefoxitin Cephradine Cephaloglycin Cephapirin
a Each column represents a group with identical R2 Cefaclor Ceſtibuten
Cefamandole Loracarbef Ceſtizoxime Cefmetazole Cefpiramide side chains.
ÎAztreonam is less immunogenic than penicillin and cephalosporins, and clinical allergic reactions to aztreonam are less common than other β-lactam antibiotics. (C)
ÎAztreonam does not cross-react with other β-lactams except for ceftazidime, with which it shares an identical R-group side chain. (B)
ÎLimited data indicate lack of significant allergic cross-reactivity between penicillin and carbapenems. (B)
> Penicillin skin test-negative patients may safely receive carbapenems. (C)
> Give penicillin skin test-positive patients and patients with a history of penicillin allergy who do not undergo skin testing carbapenems via graded challenge. (C)
Non–β-Lactam Antibiotics
ÎAny non–β-lactam antibiotic has the potential of causing an IgE- mediated reaction, but these appear to occur less commonly than with β-lactam antibiotics. (C)
ÎThere are no validated diagnostic tests for evaluation of IgE-mediated allergy to non–β-lactam antibiotics. (C) Evaluation of possible allergy to these antibiotics should be limited to situations when treatment with the drug is anticipated (rather than electively as for penicillin). (D)
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