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VA Pharmaceutical Sciences CSU

PARENTERAL ANTIBIOTIC ALLERGY CROSS-SENSITIVITY CHART

KEY TO SYMBOLS:
a = Cefazolin may be safely administered to patients with history of
allergy to penicillins including anaphylaxis, EXCEPT in those with
severe delayed skin reactions - e.g. Stevens-Johnson syndrome,
toxic epidermal necrolysis, drug reaction with eosinophilia and
systemic symptoms (DRESS).
Amikacin
Ampicillin
Azithromycin
b = May consider using if non-anaphylactic reaction to the penicillin or
cephalosporin; monitor closely
Amikacin
Cefazolin
c = There is little potential for cross-reactivity between penicillin /
Ampicillin Cefotaxime cephalosporins and carbapenems; however, monitor closely if
previous anaphylactic reaction to penicillins or cephalosporins
Azithromycin Cefoxitin
Ceftazidime
X = Potential for cross-sensitivity
Cefazolin a
Ceftriaxone

Chloramphenicol
Cefotaxime b X Blank = Not cross-sensitive

Cefuroxime
Cefoxitin b X X

Ciprofloxacin

Cotrimoxazole (Sulfa)
Ceftazidime b X X X

Clindamycin
Ceftriaxone b X X X X
Cefuroxime b X X X X X

Cloxacillin
Chloramphenicol

Daptomycin
Ciprofloxacin
Clindamycin

Ertapenem
Erythromycin
Cloxacillin X a b b b b b
Cotrimoxazole (Sulfa)

Gentamicin
Daptomycin

Imipenem
Levofloxacin
Ertapenem c c c c c c c c

Piperacillin/Tazobactam
Meropenem
Erythromycin X

Metronidazole
Gentamicin X

Moxifloxacin
Imipenem c c c c c c c c X
Levofloxacin X

Penicillin
Meropenem c c c c c c c c X X

Streptomycin
Metronidazole

Tigecycline
Moxifloxacin X X

Tobramycin
Penicillin X a b b b b b X c c c

Vancomycin
Piperacillin/Tazobactam X a b b b b b X c c c X
Streptomycin X X
Tigecycline
Tobramycin X X X
Vancomycin

Updated: Oct 2018 ASPIRES/PHARMACY