Penicillins and other β-lactam antibiotics are the most common elicitors of allergic drug reaction. However, data on the pattern of clinical reaction types elicited by specific β-lactams are scarce and inconsistent. We aimed to determine patterns of β-latam allergy, i.e. the association of a clinical reaction type with a specific β-lactam antibiotic. We retrospectively evaluated data from 800 consecutive patients with suspected β-lactam hypersensitivity over a period of 11 years in a single German Allergy Center. β-lactam hypersensitivity was definitely excluded in 595 patients, immediate-type (presumably IgE-mediated) hypersensitivity was diagnosed in 70 and delayed-type hypersensitivity in 135 cases. Most (59 out of 70, 84.3%) immediate-type anaphylactic reactions were induced by a limited number of cephalosporins. Delayed reactions were regularly caused by an aminopenicillin (127 out of 135, 94.1%) and usually manifested as a measles-like exanthem (117 out of 135, 86.7%). Intradermal testing proved to be the most useful method for diagnosing β-lactam allergy, but prick testing was already positive in 24 out of 70 patients with immediate-type hypersensitivity (34.3%). Patch testing in addition to intradermal testing did not provide additional information for the diagnosis of delayed-type hypersensitivity. Almost all β-lactam allergic patients tolerated at least one, usually several alternative substances out of the β-lactam group. We identified two patterns of β-lactam hypersensitivity: aminopenicillin-induced exanthem and anaphylaxis triggered by certain cephalosporins. Intradermal skin testing was the most useful method to detect both IgE-mediated and delayed-type β-lactam hypersensitivity.

中文翻译：

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在一个德国过敏中心内，β-内酰胺超敏反应的主要模式：由氨基青霉素引起的高热，由头孢菌素引起的过敏反应

青霉素和其他β-内酰胺类抗生素是过敏性药物反应的最常见诱因。然而，由特定的β-内酰胺类引起的临床反应类型模式的数据很少且不一致。我们旨在确定β-内酰胺过敏的模式，即临床反应类型与特定的β-内酰胺抗生素的关联。我们回顾性评估了来自11家德国过敏中心的800名连续11年怀疑患有β-内酰胺超敏反应的患者的数据。绝对排除了595例患者的β-内酰胺超敏反应，其中70例诊断为速发型（可能是IgE介导），135例诊断为迟发型超敏反应。大多数（70个中的59个，占84.3％）速发型过敏反应是由有限数量的头孢菌素引起的。迟发性反应通常是由氨基青霉素引起的（135例中有127例，占94.1％），通常表现为麻疹状的发烧（135例中有117例，占86.7％）。皮内测试被证明是诊断β-内酰胺过敏的最有用的方法，但是在70例立即型超敏反应患者中，有24例点刺测试已经呈阳性（34.3％）。除皮内试验外，斑贴试验未提供诊断迟发型超敏反应的其他信息。几乎所有的β-内酰胺过敏患者都能耐受β-内酰胺组中的至少一种，通常是几种替代物质。我们确定了β-内酰胺超敏反应的两种模式：氨基青霉素引起的高热和某些头孢菌素引发的过敏反应。