Oral desensitization to penicillin in necrotizing (malignant) external otitis

Penicillin allergy can complicate the treatment of life-threatening infections. When a beta-lactam (penicillin) drug is the treatment of choice, true allergy can be safely overcome by a recent, oral method of desensitization to penicillin. Patients with positive skin test results can be desensitized within four hours with oral, subcutaneous, and then intramuscular administration of progressively increased doses of penicillin G. We used this method successfully in a patient with severe necrotizing (malignant) external otitis.