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Penicillin resensitization among hospitalized patients
P J Parker1, J T Parrinello, J J Condemi
1Department of Medicine, University of Rochester School of Medicine and Dentistry, N.Y. 14642.
The Journal of Allergy and Clinical Immunology
|August 1, 1991
Summary
Penicillin allergy patients receiving intravenous beta-lactam antibiotics may become resensitized. Repeat skin testing is recommended before future beta-lactam exposure to ensure safety in penicillin-allergic individuals.
Area of Science:
- Clinical Immunology
- Infectious Diseases
- Pharmacology
Background:
- Penicillin allergy is common, leading to avoidance of beta-lactam antibiotics.
- Resensitization rates after treatment in allergic patients are not well-established.
- Accurate assessment of penicillin allergy is crucial for patient management.
Purpose of the Study:
- To determine the frequency of penicillin resensitization after beta-lactam antibiotic treatment.
- To evaluate skin test conversion in patients with a history of penicillin allergy.
- To assess the impact of intravenous versus oral administration on resensitization.
Main Methods:
- Prospective study involving 18 patients with a history of penicillin allergy.
- Patients underwent negative skin testing before treatment with beta-lactam antibiotics.
- Repeat skin testing was performed 1 to 12 months post-treatment.
Main Results:
- Three out of 18 patients (16.7%) converted to skin test positive post-treatment.
- All three positive conversions occurred in patients receiving intravenous antibiotics.
- Reactions were observed to penicillin G, benzylpenicilloyl polylysine, and minor determinant mixture.
Conclusions:
- Intravenous beta-lactam therapy is associated with a significant rate of penicillin resensitization.
- Repeat skin testing is essential for penicillin-allergic patients before future beta-lactam antibiotic exposure.
- Current practices of advising repeat testing are confirmed and reinforced.
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