To Be or NOT to Be…..PENICILLIN ALLERGIC?
Penicillin is the most commonly reported medication allergy, and is self-reported by about 5 to 10 percent of patients. However, according to Dr Kusum Sharma, Director, Allergy & Asthma Clinics at AKANE Institute of Allergy, Asthma & Sleep Medicine, most of these patients are not truly penicillin allergic. In large-scale studies of penicillin skin testing, approximately 85 to 90 percent of these individuals are found not to have positive skin tests and are able to tolerate penicillins.
Nine out of ten people who believe they are allergic can take penicillin without a problem, either because they were never truly allergic or because their allergy to penicillin has resolved over time. People who have a remote history of allergic reaction to a medication may become less allergic as time passes.
The good news is that recently FDA has approved Pre-Pen so allergists can now offer skin testing for penicillin. This is covered by most insurance companies. Testing usually takes about one hour to complete. The skin is pricked and injected with Pre-Pen and observed for a reaction. A positive skin reaction is an itchy, red bump that lasts about half an hour and then resolves. A positive test indicates that the person is truly allergic and should continue to avoid penicillins.
If the patient completes the skin testing without a positive reaction,
a single oral dose of full strength penicillin is commonly given to confirm that the patient does not have an allergy to the medication. Dr Kusum Sharma then notifies the patients’ other treating doctors so they can remove the penicillin allergy label from their medical charts.
According to Dr Sharma, there are many advantages of removing the penicillin allergy label:
- Millions of people are incorrectly labeled as penicillin allergic for some “non-allergic adverse reaction.”
- Doctors can have the freedom to choose any antibiotic
- Using Penicillins allows to reduce cost as co-pay for these antibiotics is usually lower.
- Penicillins are still considered very effective and less toxic than most other antibiotics.
- The use of narrow spectrum antibiotics like most Penicillins rather than other broad spectrum antibiotics helps prevent emergence of multi-drug resistance organisms.
- So as Dr. Sharma puts it, for many of us the choice is ours: To be or not to be…Penicillin allergic!