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In this review, we focus on clinically significant immunologic cross-reactivity in patients with confirmed penicillin allergy to cephalosporins, and the structural involvement of the R 1 and R 2 chemical side chains of the cephalosporins causing IgE-mediated cross-reactivity ... With over 18 years of experience in Allergy Elimination and 50 years in the practice of Clinical Nutrition. Every patient that presents in my office demonstrates three interference factors affecting their health and contributing to their complaint(s). 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