Table 4:

Administration of penicillin or cephalosporins in the context of a previous reaction (1)

Drug administered	Reaction to cephalosporin	Reaction to penicillin
Cephalosporin	Graded challenge to cephalosporin with different side chain or Skin test to different cephalosporin If result is negative, give via graded challenge If result is positive, avoid or desensitize	Penicillin skin testing Give cephalosporin if result is negative Avoid cephalosporin, give cephalosporin via graded challenge or desensitize to cephalosporin if result is positive or Cephalosporin skin testing Give cephalosporin via graded challenge if result is negative Avoid or desensitize to cephalosporin if results is positive
Penicillin	Graded challenge to penicillin or Skin test to penicillin If result is negative, give penicillin If result is positive, give alternate drug or desensitize to penicillin	Penicillin skin test If result is positive, avoid penicillin or desensitize If result is negative, give penicillin via challenge