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Complete recovery from prolonged cardio‐pulmonary resuscitation following anaphylactic reaction to readministered intravenous cefazolin
Author(s) -
Gibbs M. W.,
Kuczkowski K. M.,
Benumof J. L.
Publication year - 2003
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2003.00028.x
Subject(s) - medicine , cefazolin , anesthesia , cardiopulmonary resuscitation , resuscitation , anaphylaxis , epinephrine , intubation , allergy , antibiotics , microbiology and biotechnology , immunology , biology
We describe a patient who developed a type I anaphylactic reaction to intravenous cefazolin. The patient had no known drug allergies and had previously received intraoperative intravenous cefazolin 2 months prior without any problems. Forty‐fives after receiving cefazolin 1 g i.v. and while fully awake, the patient experienced shortness of breath, became unconscious, and then suffered a cardiac arrest. Resuscitation included endotracheal intubation, external cardiac compression, electrical defibrillation and multiple large doses of epinephrine, atropine, and sodium bicarbonate over the course of 2.5 h and three cardiac arrests. Nevertheless, the patient fully recovered. The intent of this case report is to address widely held concerns regarding cross‐reactivity of cephalosporin, particularly cefazolin, to penicillin, the legitimacy of test dosing as a means to safely identify patients who will have an allergic reaction to cephalosporins and comment on patient‐related predictors of survival following cardiopulmonary resuscitation and the good outcome in this case.