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Penicillin allergy: consider trying penicillin again
Mercedes E Arroliga1, Lily Pien
1Section of Allergy and Immunology, Department of Pulmonary and Critical Care Medicine, The Cleveland Clinic, Cleveland Clinic Foundation, OH 44195, USA. arrolim@ccf.org
Cleveland Clinic Journal of Medicine
|April 19, 2003
Summary
A penicillin allergy history does not prevent future penicillin use. Skin testing and desensitization allow most patients with penicillin allergy to safely take the antibiotic.
Area of Science:
- Immunology
- Pharmacology
- Clinical Medicine
Background:
- Penicillin allergy is a common concern, leading to avoidance of this crucial antibiotic.
- Alternative antibiotics are often broader-spectrum, increasing risks of resistance and side effects.
Purpose of the Study:
- To evaluate the safety and efficacy of reintroducing penicillin in patients with a documented penicillin allergy.
Main Methods:
- Utilized penicillin skin testing to assess immediate hypersensitivity.
- Administered graded doses of penicillin for desensitization in selected high-risk patients.
- Monitored patients for adverse reactions during and after re-challenge.
Main Results:
- The majority of patients with a history of penicillin allergy tolerated penicillin re-administration.
- Skin testing accurately identified patients at low risk for immediate reactions.
- Desensitization was successful in enabling penicillin tolerance for those with confirmed IgE-mediated allergy.
Conclusions:
- A history of penicillin allergy should not automatically preclude its use.
- Penicillin skin testing and desensitization are valuable tools for safely reintroducing penicillin.
- These strategies can help preserve penicillin as a treatment option, reducing reliance on alternative antibiotics.
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