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CURRENT ISSUE

№3' 2021

THERAPY

International Medical Journal, Vol. 27., Iss. 3, 2021, P. 5−9.


DOI (https://doi.org/10.37436/2308-5274-2021-3-1)

CROSS-REACTIVITY TO ANTIBIOTICS


Bereznyakov I. G., Imanova N. I., Pozhar V. I., Doroshenko O. V., Lebedynska M. M., Sydorov D. Yu.

Kharkiv Medical Academy of Postgraduate Education, Ukraine

The cross−reactivity between antibiotics affects the choice of them to treat bacterial infections. If patients had allergic reactions to any antibiotics in the past, the physician usually prescribes an alternative drug. For optimal treatment of such patients, certain circumstances should be considered: hypersensitivity to antibiotics subsides over time, cross−reactivity is rare even within one class of antibiotic; the use of alternative antibiotics is associated with increased treatment costs, prolonged hospital stay and enhanced risk of infection by resistant microorganisms. Cross−reactivity between β−lactams is infrequent and stipulated by structural similarity of R1−side chains. Hypersensitivity to a certain cephalosporin does not yet indicate the one to a whole class, and in the presence of an allergy to cephalosporins of any generation, there will be no cross−reaction to another drug if their molecules have different side chains. At anamnestic indications for immediate allergic reactions to fluoroquinolones, the use of all members of this class should be avoided. Most patients with hypersensitivity to one macrolide tolerate another with a different number of atoms in the lactone ring. In the presence of anamnestic indications for allergic reactions to aminoglycosides of the deoxystreptamine group, the use of all such drugs should be avoided too. If the patient has a history of allergic reactions to glycopeptides, the use of oxazolidinones is safer. Different imidazoles should not be used in patients with known hypersensitivity to metronidazole. If there is a high probability of an allergic reaction of the first type in a patient in the past, it is better to plan treatment together with an allergist / immunologist.

Key words: antibiotic, cross−reactivity, allergic reaction.


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