“Very few” people who think they have a penicillin allergy actually do


Penicillin 1


Most patients who have a history of penicillin allergy are not really allergic to penicillin.

According to a report this week in JAMAless than 10% [of people] with penicillin allergy histories who are tested in specialized allergy clinics are found to be at risk for acute allergy to penicillin’s.”

Moreover: “Careful assessment of a patient’s history of antibiotic allergy, combined with testing strategies, will result in very few of the estimated 25 million to 30 million US residents labeled as allergic to penicillin to not receive penicillin’s or other [penicillin-like] antibiotics when those drugs are indicated.

So if for any reason you think you’re allergic to penicillin the authors recommend that you arrange for an allergy specialist to do skin testing (above photo).

The reason? Not using penicillin or a penicillin-derivative when you should, means you’re (unnecessarily) using something that is less effective, more toxic, and more expensive. And thus, in hospital settings, you’re facing a “greater risk for prolonged length of stay, readmissions, and acquisition of multidrug-resistant organisms.”

So for example, when you don’t use the antibiotic of choice for Staph aureus:


The inability to use an antistaphylococcal penicillin (e.g. nafcillin) for patients with methicillin-susceptible Staphylococcus aureus sepsis, or other serious infections, for which penicillin’s are the first-line therapy … places patients at risk of treatment failure, resistance generation, and increased mortality.” [My emphasis.]


Childhood penicillin allergies will disappear “in most patients … after a decade.” But there’s another reason why you may think you have a penicillin allergy when you don’t: “… viral rashes in children may be mistaken for penicillin allergy when these children are unnecessarily given antibiotics for a viral syndrome.”





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