title: Cross-reactivity of cefotetan and ceftriaxone antibodies, associated with hemolytic anemia, with other: cephalosporins and penicillin.
abstract: Most drug-induced immune hemolytic anemias since the late 1980s have been caused by the second- and third-generation cephalosporins, cefotetan and ceftriaxone, respectively. Cross-reactivity of cefotetan and ceftriaxone antibodies with other cephalosporins or penicillin has been studied only minimally. We tested 7 serum samples previously identified to contain cefotetan antibodies and one serum sample previously identified to contain ceftriaxone antibodies against 9 other cephalosporins, penicillin, and 7-aminocephalosporanic acid in the presence of RBCs and also used hapten inhibition to indicate cross-reactivity. Serum samples containing cefotetan antibodies showed some cross-reactivity with cephalothin and cefoxitin (and to a much lesser extent with penicillin and ceftazidime). The ceftriaxone antibodies showed very weak cross-reactivity with cefotaxime, cefamandole, and cefoperazone. There was very little cross-reactivity between cefotetan antibodies and the drugs tested in the present study. We have no data to determine whether the in vitro data relate to in vivo reactivity.
authors.affiliation: American Red Cross Blood Services, Southern California Region, Los Angeles 90006, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Arndt
authors.forename: George
authors.initials: G
authors.lastname: Garratty
mesh_terms: D000743:Anemia, Hemolytic / Q000276:immunology*; D000906:Antibodies / Q000276:immunology*; D002435:Cefamandole / Q000276:immunology; D002438:Cefoperazone / Q000276:immunology; D002439:Cefotaxime / Q000276:immunology; D015313:Cefotetan / Q000276:immunology*; D002440:Cefoxitin / Q000276:immunology; D002443:Ceftriaxone / Q000276:immunology*; D002478:Cells, Cultured; D002511:Cephalosporins / Q000276:immunology*; D002512:Cephalothin / Q000276:immunology; D003429:Cross Reactions; D006801:Humans; D008956:Models, Chemical; D010406:Penicillins / Q000276:immunology*
chemical_list: D000906:Antibodies; D002511:Cephalosporins; D010406:Penicillins; D015313:Cefotetan; D002435:Cefamandole; D002440:Cefoxitin; D002443:Ceftriaxone; D002438:Cefoperazone; C030735:7-aminocephalosporanic acid; D002439:Cefotaxime; D002512:Cephalothin