Roughly ten percent of Americans report they are allergic to penicillin, and that’s a lot of people! The problem is, more than 90% of people who say they are allergic to penicillin (or whose doctors say so) are really not. Of those who are truly allergic to penicillin, a very small number (1-5 in 10,000) have the most severe reaction: anaphylaxis. And most people who are truly allergic — even those with a history of anaphylaxis — can actually outgrow their penicillin allergy!
With the growing crisis of antibiotic resistance gaining momentum globally, now is the time for people to consider finding out once and for all whether or not they are allergic to penicillin. Alternative antibiotics tend to be broader in scope (they destroy more bad — and good — bacteria in a patient’s body than penicillin, which has a narrow spectrum of effectiveness), and, therefore have a greater propensity for causing more numerous and severe side effects. Also, alternatives to penicillin are not abundant, with few new antibiotics on the research and development horizon. And now, as Sergei Belenky, M.D., Ph.D. from Pediatric Alliance — Allergy, Asthma and Immunology Division tells us, clinical outcomes of hospitalized patients are worse when they have “Penicillin Allergic” affixed to their charts:
A recent study published in March 2014 in the Journal of Allergy and Clinical Immunology found that patients admitted for various reasons to hospital and labeled as penicillin allergic experience 10% more serious antibiotic-resistant infections, including C. difficile, Methicillin-resistant Staphylococcus aureus (MRSA), and Vancomycin-resistant Enterococcus faecium (VREF) and longer hospital stays.
Dr. Belenky asserts that skin testing for penicillin allergy is gaining clinical significance:
Clearly, getting rid of or confirming penicillin allergy in kids would be very important for them, their parents, and us their physicians. The steady growth of macrolide resistance is in large part a result of frequently unnecessary avoidance of the penicillin group of antibiotics.
Skin testing for penicillin (and its minor determinant) is available, accurate and can safely be performed. Only allergists perform allergy skin testing to penicillin, but this test is available and surely more kids and adults with a history of a poorly defined skin eruption to penicillin vs. an infection-related skin rash should be tested to Penicillin G and PrePen.
Parents who wish to have skin testing for penicillin allergy performed can discuss it with their pediatrician at their child’s next checkup, or get more information at Dr. Belenky’s office.