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AI-Generated response:

if a patient is allergic to cefdinir, can they be prescribed keflex?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Prescribing Keflex (cephalexin) to a patient allergic to cefdinir is generally contraindicated due to the risk of cross-reactivity among cephalosporins, which can lead to serious hypersensitivity reactions.[1-3]

  • Cefdinir and cephalexin both belong to the cephalosporin class of antibiotics, and cross-reactivity can occur among cephalosporins.

  • Hypersensitivity reactions to cephalosporins can range from mild rashes to severe anaphylaxis, which can be life-threatening.[1]

  • The structural similarities within the cephalosporin class suggest a potential for allergic cross-reactivity, especially in patients with a history of severe reactions.[1-3]

  • It is crucial to inquire about previous hypersensitivity reactions to cephalosporins before prescribing another agent from this class.[1-3]

  • If a patient has experienced a severe hypersensitivity reaction to one cephalosporin, alternative classes of antibiotics should be considered to avoid the risk of a similar reaction.[1-3]

Additional info

When managing a patient with a known allergy to a cephalosporin like cefdinir, it is essential to consider the severity of the previous allergic reaction. For patients with a history of anaphylaxis or other severe reactions to cephalosporins, using another cephalosporin such as cephalexin could pose a significant risk. In such cases, it might be safer to choose antibiotics from a different class, such as macrolides or fluoroquinolones, depending on the infection being treated and the patient's overall health profile. Always ensure that emergency measures for managing severe allergic reactions are readily available if a cephalosporin is administered despite a known allergy, and consider consultation with an allergist for skin testing or desensitization protocols if a cephalosporin is necessary.

References

Reference 1

1.

Elsevier ClinicalKey Drug Monograph

Content last updated: March 4, 2024.

Contraindications And Precautions Keflex is contraindicated for use in patients with cephalosporin hypersensitivity. Cephalosporins cause hypersensitivity reactions in <= 5% of patients receiving them. A variety of hypersensitivity reactions ranging from mild rash to fatal anaphylaxis may occur. Serum sickness reactions are a form of hypersensitivity to cephalosporins and may occur after a second course of cephalosporin therapy. Certain individuals may be more susceptible to allergic reactions to cephalosporins. The structural similarity between keflex and penicillin means that cross-reactivity can occur. The incidence of cross-reactivity to cephalosporins is approximately up to 10% in patients with a documented history of allergy to penicillin. Keflex should be administered with caution to individuals with a history of hypersensitivity to penicillin. Patients who have experienced severe, immediate-type penicillin hypersensitivity (e.g., acute bronchospasm, anaphylaxis, severe dermatologic reactions) should not receive keflex. The health care professional should have immediate availability of agents used in the treatment of severe anaphylaxis in the event of a serious allergic reaction to keflex.

Warnings And Cautions 5. WARNINGS AND PRECAUTIONS • Serious hypersensitivity (anaphylactic) reactions : Prior to use, inquire regarding history of hypersensitivity to beta-lactam antibacterial drugs. Discontinue the drug if signs or symptoms of an allergic reaction occur and institute supportive measures. ( 5.1 ) • Clostridium difficile -associated diarrhea (CDAD ): Evaluate if diarrhea occurs. ( 5.2 ) • Direct Coomb's Test Seroconversion : If anemia develops during or after cephalexin therapy, evaluate for drug-induced hemolytic anemia. ( 5.3 ) • Seizure Potential : Use lower dose in patients with renal impairment. ( 5.4 ) 5.1 Hypersensitivity Reactions Allergic reactions in the form of rash, urticaria, angioedema, anaphylaxis, erythema multiforme, Stevens-Johnson syndrome, or toxic epidermal necrolysis have been reported with the use of cephalexin. Before therapy with cephalexin is instituted, inquire whether the patient has a history of hypersensitivity reactions to cephalexin, cephalosporins, penicillins, or other drugs. Cross-hypersensitivity among beta-lactam antibacterial drugs may occur in up to 10% of patients with a history of penicillin allergy. If an allergic reaction to cephalexin occurs, discontinue the drug and institute appropriate treatment. 5.2 Clostridium difficile -Associated Diarrhea Clostridium difficile - associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including cephalexin, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile . C. difficile produces toxins A and B, which contribute to the development of CDAD.

Reference 2

2.

Elsevier ClinicalKey Drug Monograph

Content last updated: February 1, 2024.

Contraindications And Precautions Kefzol is contraindicated in patients with cephalosporin hypersensitivity. Before starting therapy with kefzol, inquire about previous hypersensitivity reactions to kefzol, cephalosporins, penicillins, or other drugs. Use kefzol with caution in patients with penicillin hypersensitivity because cross-hypersensitivity among beta-lactam antibiotics has been clearly documented and may occur in up to 10% of patients with a history of penicillin allergy. If an allergic reaction to kefzol occurs, discontinue treatment with the drug. Serious acute hypersensitivity reactions may require treatment with epinephrine and other emergency measures, including oxygen, intravenous fluids, intravenous antihistamines, corticosteroids, vasopressors, and airway management, as clinically indicated. Hypersensitivity reactions, including anaphylaxis, have been reported with the administration of dextrose-containing products. These reactions have been reported in patients receiving high concentrations of dextrose (i.e., 50% dextrose). They have also been reported when corn-derived dextrose solutions were administered to patients with or without a history of corn hypersensitivity.

Reference 3

3.

Food and Drug Administration (DailyMed).

Publish date: August 4, 2018.

Warnings WARNINGS BEFORE THERAPY WITH CEFADROXIL IS INSTITUTED, CAREFUL INQUIRY SHOULD BE MADE TO DETERMINE WHETHER THE PATIENT HAS HAD PREVIOUS HYPERSENSITIVITY REACTIONS TO CEFADROXIL, CEPHALOSPORINS, PENICILLINS, OR OTHER DRUGS. IF THIS PRODUCT IS TO BE GIVEN TO PENICILLIN-SENSITIVE PATIENTS, CAUTION SHOULD BE EXERCISED BECAUSE CROSS-SENSITIVITY AMONG BETA-LACTAM ANTIBIOTICS HAS BEEN CLEARLY DOCUMENTED AND MAY OCCUR IN UP TO 10% OF PATIENTS WITH A HISTORY OF PENICILLIN ALLERGY. IF AN ALLERGIC REACTION TO CEFADROXIL OCCURS, DISCONTINUE THE DRUG. SERIOUS ACUTE HYPERSENSITIVITY REACTIONS MAY REQUIRE TREATMENT WITH EPINEPHRINE AND OTHER EMERGENCY MEASURES, INCLUDING OXYGEN, INTRAVENOUS FLUIDS, INTRAVENOUS ANTIHISTAMINES, CORTICOSTEROIDS, PRESSOR AMINES, AND AIRWAY MANAGEMENT, AS CLINICALLY INDICATED. Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including cefadroxil, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile . C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile , and surgical evaluation should be instituted as clinically indicated.

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