Cross-reactivity and tolerability of Ertapenem in patients with IgE-mediated hypersensitivity to β-lactams

Alessandro Buonomo*, Lucilla Pascolini, Angela Rizzi, Arianna Aruanno, Valentina Pecora, Anna Giulia Ricci, Simona Mezzacappa, Alessia Di Rienzo, Michele Centrone, Eleonora Nucera, Domenico Schiavino

*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivistaArticolo in rivista

7 Citazioni (Scopus)


Background and Objective: Administration of carbapenems to β-lactam-allergic patients has always been considered potentially harmful because of a 47.4% rate of cross-reactivity to imipenem reported in a single study. Nevertheless, recent studies have shown that the rate of cross-reactivity of imipenem and meropenem with penicillins is lower than 1%. The aim of this study was to evaluate the possibility of using ertapenem in patients with an established IgE-mediated β-lactam allergy. Patients and Methods: We studied all participants who came to our allergy unit and had a clinical history of immediate hypersensitivity reactions to β-lactams. The inclusion criteria were a positive skin test result to at least 1 β-lactam molecule and/or positive specific IgE (when available). All participants underwent immediate-type skin tests with several β-lactam molecules including ertapenem. Challenges with intravenous ertapenem were performed on 2 different days in patients with negative skin test results. Results: We examined 49 patients with a clinical history of immediate reactions to β-lactams. All the patients had positive skin tests and/or positive specific IgE to at least 1 β-lactam reagent and negative carbapenem skin tests. Thirty-six patients agreed to undergo the challenges and 35 tolerated the full dose of ertapenem. Conclusions: The practice of avoiding carbapenems in patients with β-lactam allergy should be abandoned considering the very low rate of cross-reactivity. β-Lactam-allergic patients who need ertapenem therapy should undergo skin tests and, if negative, a graded challenge to assess tolerability. Key words: β-lactams. IgE-mediated hypersensitivity. Ertapenem. Cross-reactivity.
Lingua originaleEnglish
pagine (da-a)100-105
Numero di pagine6
Stato di pubblicazionePubblicato - 2016


  • Ertapenem
  • β-lactams


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