Allergy to penicillin and related antibiotics is the most commonly reported drug allergy in the United States. It is estimated that 10% of patients, or 30 million people, self-report as being penicillin allergic; however, 9 out of 10 reporting penicillin allergy are not truly allergic when tested.1
A history of penicillin allergy alone is not reliable in predicting immediate allergic reactions to the drug. It has been demonstrated that patient self-reported penicillin allergy history is unreliable and many patients are unable to accurately recall the nature of the reaction they experienced.2
Details on previous reactions to penicillin will identify those who experienced classic "type I" manifestations of serious allergy such as systemic skin reactions or more serious reactions including anaphylaxis. Studies have shown that many patients labeled "penicillin allergic" may have experienced non-allergic reactions to the agent (e.g., gastrointestinal upset, headache, etc.) Indeed, many patients are erroneously labeled as "penicillin allergic" after the occurrence of a penicillin side effect when in reality they could safely be re-administered a penicillin or related antibiotic.1 Many patients can lose their IgE-mediated sensitivity over time and can safely receive penicillin antibiotics.3
Penicillin skin testing identifies the presence or absence of IgE antibodies to penicillin, information that will allow a healthcare provider to determine if penicillin or an alternative antibiotic should be given.3
- 1. Salkind, Alan, R. et all. Is This Patient Allergic to Penicillin? JAMA, May 16, 2001 - Vol. 285, No. 19
- 2. Raja, Ali S. et all. The Use of Penicillin Skin Testing to Assess The Prevalence of Penicillin Allergy in am Emergency Department. Annals of Emergency Medicine. Volume 54, No. 1: July 2009
- 3. Arroliga, Mercedes, et al. A Pilot Study of Penicillin Skin Testing in Patients with a History of Penicillin Allergy Admitted to a Medical ICU. Chest/118/4/October, 2000
- 4. Joint Task Force on Practice Parameters representing the American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273.