Specific Anticephalothin Antibody in a Patient Exposed to Multiple Cephalosporins

In the laboratory investigation of cephalosporin related immunologic problems, cephalothin (Keflin, Lilly, Indianapolis, IN) is invariably used as a representative agent, regardless of the specific cephalosporin being studied. This practice may produce false findings, since the assumption that the cephalosporins as a group are antigenically identical has never been demonstrated. The patient in this report had previously been exposed to multiple cephalosporins and developed an antibody that reacted distinctly with cephalothin-coated cells, but not with cells coated separately with penicillin and some other cephalosporins, eg, cefoxitin (Mefoxin, Merck Sharp & Dohme, West Point, PA), cephapirin (Cefadyl, Bristol, Syracuse, NY), cefamandole (Mandol, Lilly, Indianapolis, IN), and cefazolin (Ancef, Smith Kline & French, Philadelphia, PA). Based on the finding that a specific cephalothin antibody did not cross-react with other cephalosporins, the authors proposed using a panel of cephalosporin-coated cells, instead of cephalothin-coated cells alone, for the investigation of cephalosporin related immune reactions, so that: 1) the immunologic characteristics of the newer cephalosporins could be better defined; 2) the specificity of an anticephalosporin antibody could be identified; and 3) cephalosporins that may be used safely in a particular case could be selected.