TITLE:
Aztreonam Cell Mediated Hypersensitivity Cross Reactivity with Beta Lactam Antibiotics: The Possibility That It Exists
AUTHORS:
Ryan Urbas, Raxitkumar Patel, Arka Banerjee
KEYWORDS:
Piperacillin; Aztreonam; Cross; Reactivity; Allergy; Amoxicillin; Drug; Rash; Exanthem; Penicillin; Beta; Lactam; Cephalosporin; IgE; Maculopapular Rash
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.3 No.3,
March
6,
2014
ABSTRACT: A 61-year-old female with past medical history of
maculopapular rash reaction to ciprofloxacin and amoxicillin being treated for
diverticulitis develops the same rash with administration of piperacillin/tazobactam
and aztreonam. A diffuse maculopapular rash developed after the administration
of piperacillin. It resolved with discontinuation of the drug and the patient
was switched to aztreonam and a very similar rash developed subsequently. In a
review of the literature, there are no documented cases of a patient with an
allergy to both aztreonam and piperacillin/tazobactam despite in vivo cross-reactivity. Unfortunately,
there are no standardized allergy tests for aztreonam or piperacillin. This case, however, does offer the possibility
that aztreonam may not always be the right alternative to persons with
beta-lactam antibiotic allergies.