Abstract：
OBJECTIVE: Cephalosporins are one of the most prescribed antibiotics worldwide and are implicated in a wide range of hypersensitivity reactions (HSR). This review summarizes recent updates in cephalosporin hypersensitivity with a focus on diagnostic testing.
RESULTS: Reported testing strategies to evaluate different immediate and delayed cephalosporin HSR have included skin testing, in vitro testing, and diagnostic drug challenges. However, the diagnostic performance of in vivo and in vitro tests remains unclear across different hypersensitivity endotypes; adequately powered studies investigating the true positive and negative predictive value of these diagnostic modalities are needed using the reference standard of drug challenges to define cephalosporin hypersensitivity. Refinement of diagnostic testing should be guided by growth in our understanding of cephalosporin antigenic determinants. This growth will be crucial in driving further clarification of cross-reactivity between cephalosporins, and potentially delineating streamlined evaluation processes resulting in reduced unnecessary antibiotic avoidance.
RESULTS: Reported testing strategies to evaluate different immediate and delayed cephalosporin HSR have included skin testing, in vitro testing, and diagnostic drug challenges. However, the diagnostic performance of in vivo and in vitro tests remains unclear across different hypersensitivity endotypes; adequately powered studies investigating the true positive and negative predictive value of these diagnostic modalities are needed using the reference standard of drug challenges to define cephalosporin hypersensitivity. Refinement of diagnostic testing should be guided by growth in our understanding of cephalosporin antigenic determinants. This growth will be crucial in driving further clarification of cross-reactivity between cephalosporins, and potentially delineating streamlined evaluation processes resulting in reduced unnecessary antibiotic avoidance.
摘要：
目的：头孢菌素类药物是全球处方最多的抗生素之一，与多种超敏反应（HSR）有关。这篇综述总结了头孢菌素超敏反应的最新进展，重点是诊断测试。
结果：报告的评估不同即时和延迟头孢菌素HSR的测试策略包括皮肤测试，体外试验,和诊断药物挑战。然而,体内和体外试验在不同超敏反应内型中的诊断性能仍不清楚;需要足够有力的研究来调查这些诊断方式的真阳性和阴性预测值,使用药物挑战的参考标准来定义头孢菌素超敏反应.诊断测试的完善应以我们对头孢菌素抗原决定因素的理解增长为指导。这种增长对于进一步澄清头孢菌素之间的交叉反应性至关重要，并可能描述简化的评估过程，从而减少不必要的抗生素回避。
结果：报告的评估不同即时和延迟头孢菌素HSR的测试策略包括皮肤测试，体外试验,和诊断药物挑战。然而,体内和体外试验在不同超敏反应内型中的诊断性能仍不清楚;需要足够有力的研究来调查这些诊断方式的真阳性和阴性预测值,使用药物挑战的参考标准来定义头孢菌素超敏反应.诊断测试的完善应以我们对头孢菌素抗原决定因素的理解增长为指导。这种增长对于进一步澄清头孢菌素之间的交叉反应性至关重要，并可能描述简化的评估过程，从而减少不必要的抗生素回避。
