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Related Experiment Video

Updated: May 11, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Penicillin skin testing: potential implications for antimicrobial stewardship.

Nathan R Unger¹, Timothy P Gauthier, Linda W Cheung

¹Department of Pharmacy Practice, Nova Southeastern University College of Pharmacy, Palm Beach Gardens, Florida 33410, USA. nunger@nova.edu

Pharmacotherapy

|May 29, 2013

Summary

A penicillin skin test can safely identify patients without true penicillin allergies, reducing the need for second-line antibiotics and preserving current treatments against antimicrobial resistance.

Keywords:

antimicrobial stewardship benzylpenicilloyl polylysine penicillin allergy penicillin skin test β-Lactam allergy

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Published on: April 18, 2019

Area of Science:

Infectious Diseases
Clinical Pharmacology
Allergy and Immunology

Background:

The rise of multidrug-resistant organisms and limited new antibiotic development necessitate preserving current antimicrobial agents.
Antimicrobial stewardship programs are crucial for combating global antimicrobial resistance.
Penicillin skin testing offers a strategy to safely identify patients eligible for preferred beta-lactam antibiotics.

Observation:

Up to 10% of patients report a penicillin allergy, but only about 10% of those have true IgE-mediated hypersensitivity.
Penicillin skin testing can differentiate true allergies from reported allergies.

Findings:

Safely identifying non-allergic patients allows for the use of beta-lactam antibiotics, which are often preferred.
This approach can decrease reliance on second-line antibiotics like fluoroquinolones and vancomycin.

Implications:

Penicillin skin testing supports antimicrobial stewardship by enabling the use of narrower-spectrum beta-lactams.
Pharmacists play a key role in implementing and managing penicillin skin test programs.
Wider adoption could significantly impact antibiotic prescribing patterns and combat resistance.