Abstract: Objective To understand the characteristics and relevant factors of anaphylactic shock induced by cephalosporin injection with negative skin test, in order to provide a reference for safe medication in clinic. Methods The case reports of anaphylactic shock induced by cephalosporin with negative skin test, reported in domestic medical journal in the last ten years, were searched and filtered. Patient's age, gender, primary diseases, allergic history, skin test, drug use, routes of administration, selection of solvent, time of occurrence of anaphylactic shock, and clinical manifestations, were collected and analyzed． Results 121 cases with anaphylactic shock were collected, of which the youth was the most common (45.45%), followed by the old (19.01%). 75.21% of the cases had no drug allergic history, 15.70% unclear. 90.91% of skin tests were done using diluted cephalosporin, and 9.09% using penicillin or cefazolin. The most common drugs leading to anaphylactic shock were the third generation cephalosporin. There were also problems in the medication of patients, for example single drug dosages for some patients were too large. The percentage of patient with immediate anaphylactic shock was 81.82%, while 18.2% with delayed anaphylactic shock. 72.73% anaphylactic shock occurred within 30 min after administration. Clinical symptoms mainly involved respiratory system, circulation system and central nervous system. The total mortality was 10.74%. Conclusion The use of cephalosporin and skin test need to be further standardized in China. Patients treated with cephalosporin need to be monitored closely, even if the skin test Results are negative, so as to ensure the safety of drug use.

Key words: anaphylactic shock, cephalosporin, negative skin test, literature analysis