Beta-lactam allergy in adults with cystic fibrosis

J Cyst Fibros. 2007 Jul;6(4):297-303. doi: 10.1016/j.jcf.2006.11.001. Epub 2006 Dec 19.


Background: Allergic reactions to one or more beta-lactam antibiotic can pose a management problem in patients with cystic fibrosis (CF), and may limit antibiotic choice.

Method: The aim of this study was to assess the prevalence of allergy to anti-pseudomonal beta-lactam antibiotics in an adult CF centre and to assess variables, which may contribute to the development of allergic reactions. A questionnaire-based interview and a review of medical records were performed.

Results: Of the 150 patients, 54 (36%) had allergic reactions to one or more beta-lactam antibiotics and 20 (19%) had allergic reactions to multiple beta-lactam antibiotics. The proportion of patients allergic to specific beta-lactam antibiotics varied from 10% to 26%. Rates of reactions were highest for penicillins and cephalosporins, intermediate for carbepenems and lowest for aztreonam. Of all reactions, 40% occurred within 24 h of the commencement of an individual antibiotic course. Patients with one or more beta-lactam allergic reactions had received greater cumulative exposure (p<0.0001), were older (p=0.016) and had lower lung function (p=0.037) than patients without a history of beta-lactam allergy. Cystic Fibrosis transmembrane regulator (CFTR) status, gender, peripheral blood eosinophil count and total IgE concentrations were not different in patients with allergic reactions.

Conclusions: This study demonstrates that the prevalence of allergic reactions to beta-lactam antibiotics is high in adults with CF. Increasing age; cumulative exposure and decreasing FEV(1) were associated with the development of allergy.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / physiopathology
  • Drug Hypersensitivity / epidemiology*
  • Female
  • Forced Expiratory Volume / drug effects
  • Forced Expiratory Volume / physiology
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Queensland / epidemiology
  • Retrospective Studies
  • Risk Factors
  • beta-Lactams / adverse effects*
  • beta-Lactams / therapeutic use


  • beta-Lactams