| Penicillin drug reaction | |
|---|---|
| Classification and external resources | |
| ICD-10 | Y40.0 |
| ICD-9 | E930.0 |
A Penicillin drug reaction is an adverse drug reaction associated with the use of penicillin.
Common adverse drug reactions (≥1% of patients) associated with use of the penicillins include diarrhea, hypersensitivity, nausea, rash, neurotoxicity, urticaria, and superinfection (including candidiasis). Infrequent adverse effects (0.1–1% of patients) include fever, vomiting, erythema, dermatitis, angioedema, seizures (especially in epileptics), and pseudomembranous colitis.[1]
Pain and inflammation at the injection site is also common for parenterally administered benzathine benzylpenicillin, benzylpenicillin, and, to a lesser extent, procaine benzylpenicillin.
Although penicillin is still the most commonly reported allergy, less than 20% of all patients that believe that they have a penicillin allergy are truly allergic to penicillin;[2] nevertheless, penicillin is still the most common cause of severe allergic drug reactions.
Allergic reactions to any β-lactam antibiotic may occur in up to 1% of patients receiving that agent.[3] The allergic reaction is a Type I hypersensitivity reaction. Anaphylaxis will occur in approximately 0.01% of patients.[1] It has previously been accepted that there was up to a 10% cross-sensitivity between penicillin-derivatives, cephalosporins, and carbapenems, due to the sharing of the β-lactam ring.[4][5] However recent assessments have shown no increased risk for cross-allergy for 2nd generation or later cephalosporins.[6][7] Recent papers have shown that a major feature in determining immunological reactions is the similarity of the side chain of first generation cephalosporins to penicillins, rather than the β-lactam structure that they share.[8]