Ms. Wang had urinary tract infection for 9 months. Can she still use cephalosporin allergic to penicillin?

Ms. Wang has been pregnant for 9 months, and the baby is happy to wait for the baby to fall in a temporary family. Ms. Wang has a urinary tract infection. The doctor said that she needs to use cephalosporin that is safer to pregnant women for anti -infective treatment.But Ms. Wang remembered that she had rashes when she used penicillin 2 years ago. At that time, the doctor said that it was penicillin allergies. In the futurequestion.There are not many medicines for pregnant women. Can Ms. Wang who is allergic to penicillin can use cephalosporin?

Why can penicillin cause allergic reactions

The allergic response is the antigen antibody reaction. The cause of penicillin allergic reactions is mainly caused by the degradation products in penicillin solutions, chicanol, chicoos, and 6APA.These substances produce potential antigens when semi -antigen and protein or other macromolecules, which stimulates the body to produce various antibodies. The combination of antigen antibodies causes allergic reactions.

Therefore, the "China Pharmacopoeia-Clinical Medicine Instructions" (2010 version) requires that patients’ allergies must be consulted before using penicillin drugs, as well as testing penicillin leather tests.

Generally, penicillin allergic reactions can be manifested as rash, drug heat, vascular neurological edema, serum disease response, allergic shock, etc. Among them, an allergic shock is the most serious.Allergic shocks occur within a few minutes after injection. Symptoms are dyspnea, purple, blood pressure decrease, coma, limb rigidity. In the end, it can die in a short time.If allergies are occurred, the drug must be discontinued immediately and related treatment; if an allergic shock occurs, it must be immediately rescued and related to adrenaline and other related treatment.

Cefacitin and penicillin have a cross -allergic reaction

The allergic reaction caused by cephalosporin is also an antigen antibody response. It is caused by the R1 side chain on its structure as the antigen. When the cephalosporin is the same or similar to the R1 side chain of penicillin, a cross -allergic reaction may occur.Therefore, when patients with penicillin allergies use cephalosporin, a cross -allergic reaction occurs is related to the selected cephalosporin structure.Therefore, the "China Pharmacopoeia-Clinical Medicine Instructions" (2010 version) requires the history of allergies for patients before using cephalosporin drugs.

Can those who are allergic to penicillin be used?

This has to be treated separately according to the severity of allergic reactions.

1. If the patient has serious allergic reactions such as allergic shock to penicillin, penicillin and cephalosporin drugs should be prohibited;

2. If patients are only allergic to penicillin, such as mild rash, cephalosporin antibacterial drugs can still be selected carefully according to the condition.The existing research shows that the incidence of cross -allergic reactions between penicillin and the first and second -generation cephalosporin is significantly higher than that of the third and fourth generations. Therefore, three or four generations of cephalosporin should be selected.For specific pharmaceutical varieties, you can consult the pharmacist. The pharmacist can make the most scientific and reasonable recommendation from the perspective of the drug structure and consider the possible pathogenic bacteria.

Finally, we returned to Ms. Wang’s question.Ms. Wang had rashes when using penicillin at the time, which was a general allergic reaction.Therefore, the pharmacist suggested that the cephalosporin can be used under the care of the doctor, and the pharmacist will make specific drug recommendations to the doctor.

Literary/Guangzhou Medical University Affiliated Hospital Sub -Station Mei Yan (Tan Xiangping, branch of the Third Hospital of Guangzhou Medical University, and Li Xiang, a sub -station of Guangzhou Chest Hospital, also contributed to this article)

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