Anaphylactic shock caused by a selective allergy to ceftriaxone: A case report

Abstract

Ceftriaxone has been widely used due to once daily dosing. However, case with anaphylaxis secondary to ceftriaxone has been documented and the other β-lactam might be a caution. Objective: To reported an 89-year-old patient who had history of Type I hypersensitivity to ceftriaxone. Results: This case could be received imipenem following by piperacillin/tazobactam for a few days with a good clinical outcome before antibiotic de-escalation. After switching to ceftriaxone, this pateint developed anaphylactic shock and the appropriate resuscitation was performed immediately. Subsequently, she had sepsis several times treated by ampicillin, cloxacillin, piperacillin/tazobactam, and imipenem without any serious events. With our case report, the other β-lactam might be therapeutic choices in the case of selective allergy to one of them, but it can be hard to know except, they have experienced such medications. Moreover, the rechallenge β-lactam in Type I hypersensitivity does not routinely reintroduce. Conclusion: Thus, the other classes of antimicrobial agents, not β-lactam, are the preferred options.