Occupational asthma induced by cephalosporins

A 20-yr-old pharmaceutical worker who developed attacks of shortness of bre ath and wheezing 9 months after beginning work on a process in which cefadr oxil powder was bottled or encapsulated,will be described. Skin test with cefaxodril was negative. Baseline spirometry and methacholin e inhalation test were normal. A controlled bronchial challenge test was ca rried out in a closed-circuit system with assessment of respirable dust con centration. Exposure to cefadroxil powder at a mean concentration of 10 mg.m(-3) for 10 min elicited an isolated immediate asthmatic response, but no response was observed to control challenge with lactose. Single-blind oral challenge te st with amoxicillin up to 500 mg was well tolerated, whereas the oral chall enge with cephalexin (25 mg) elicited an immediate asthmatic response. This patient had developed occupational asthma caused by inhalation of cefa droxil as confirmed by specific inhalation test. Since she tolerated oral a moxicillin, a synthetic penicillin with the side-chain identical to that of cefadroxil, it seems that she may be sensitized to the dihydrothiazine rin g of cephalosporins.