Cross-allergy between penicillins and cephalosporins: a paradigm shift


  • Liliana Dias Department of Allergy and Clinical Immunology, Unidade I, Centro Hospitalar Vila Nova Gaia/ Espinho
  • Cláudia Pedrosa Immunoallergology and Pediatric Pulmonology Unit, Department of Pediatrics, Unidade II, Centro Hospitalar Vila Nova de Gaia/Espinho



cephalosporin, cross-reactivity, penicillin, side chain


Allergic reactions to beta-lactam antibiotics are the most common cause of allergic drug reactions. The incorrect diagnosis prevents patients from receiving a highly effective therapy.

The potential cross-reactivity between penicillin and cephalosporin has very significant therapeutic implications. Penicillins and cephalosporins share a common beta-lactam ring and side chains. A number of studies indicate that the R1 side chain, rather than the ring itself, is the determining factor for cross-reactivity.

Herein is presented a review of the immunologic mechanisms implicated in penicillin and cephalosporin cross-reactivity and a practical approach to the use of cephalosporins in patients allergic to penicillin.


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How to Cite

Dias L, Pedrosa C. Cross-allergy between penicillins and cephalosporins: a paradigm shift. REVNEC [Internet]. 2022Apr.4 [cited 2023Sep.30];31(1):31-7. Available from:



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