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.
Cite this paper
Urbas, R. , Patel, R. and Banerjee, A. (2014) Aztreonam Cell Mediated Hypersensitivity Cross Reactivity with Beta Lactam Antibiotics: The Possibility That It Exists. Case Reports in Clinical Medicine
, 135-138. doi: 10.4236/crcm.2014.33033
 James, C.W. and Gurk-Turner, C. (2001) Cross-Reactivity of Beta-Lactam Antibiotics. Baylor University Medical Center Proceedings, 14, 106-107.
 Vega, J.M., Blanca, M., Garcia, J.J., Miranda, A., et al. (1991) Tolerance to Aztreonam in Patients Allergic to Beta-Lactamantibiotics. Allergy, 46, 196-202. http://dx.doi.org/10.1111/j.1398-9995.1991.tb00570.x
 Frumin, J. and Gallagher, J.C. (2009) Allergic Cross-Sensitivity between Penicillin, Carbapenem, and Monobactam: What Are the Chances? The Annals of Pharmacotherapy, 43, 304-315. http://dx.doi.org/10.1345/aph.1L486
 Buonomo, A., Nucera, E., De Pasquale, T., Pecora, V., et al. (2011) Tolerability of Aztreonam in Patients with Cell-Mediated Allergy to &beta-Lactams. International Archives of Allergy and Immunology, 155, 155-159. http://dx.doi.org/10.1159/000318844
 Patriarca, G., Schiavano, D., Lombardo, C., et al. (2008) Tolerability of Aztreonam in Patients with IgE-Mediated Hypersensitivity to Beta-Lactams. International Journal of Immunopathology and Pharmacology, 21, 375-379.
 Saxon, A., Hassner, A., Swabb, E.A., Wheeler, B. and Adkinson Jr., N.F. (1984) Lack of Cross-Reactivity between Aztreonam, a Monobactam Antibiotic, and Penicillin in Penicillin-Allergic Subjects. The Journal of Infectious Diseases, 149, 16-22. http://dx.doi.org/10.1093/infdis/149.1.16
 Adkinson Jr., N.F., Saxon, A., Spence, M.R. and Swabb, E.A. (1985) Cross-Allergenicity and Immunogenicity of Aztreonam. Clinical Infectious Diseases, 7, S613-S621. http://dx.doi.org/10.1093/clinids/7.Supplement_4.S613
 Saxon, A. (1985) Investigation into the Immunologic Cross-Reactivity of Aztreonam with Other Beta-Lactam Antibiotics. The American Journal of Medicine, 78, 19-26. http://dx.doi.org/10.1016/0002-9343(85)90198-6
 Romano, A., Gaeta, F., Valluzzi, R.L., Caruso, C., Rumi, G. and Bousquet, P.J. (2010) IgE-Mediated Hypersensitivity to Cephalosporins: Cross-Reactivity and Tolerability of Penicillins, Monobactams, and Carbapenems. Journal of Allergy and Clinical Immunology, 126, 994-999. http://dx.doi.org/10.1016/j.jaci.2010.06/052
 Caimmi, S., Caimmi, D., Lombardi, E., Crisafulli, G., Franceschini, F., Ricci, G. and Marseglia, G.L. (2011) Antibiotic Allergy. International Journal of Immunopathology and Pharmacology, 24, S47-S53.
 Adkinson, N.F. (1990) Immunogenicity and Cross-Allergencity of Aztreonam. The American Journal of Medicine, 88, S12-S15. http://dx.doi.org/10.1016/0002-9343(90)90081-N