Five Things You Need to Know About Penicillin Allergy
Penicillin was a wonder drug when it was first introduced in 1928 – and it has revolutionized medicine ever since. We can now treat infections that used to be a death sentence.
But what if you believe you’re allergic to it? You may still have options. Up to 10 percent of people report being allergic to penicillin, according to the Centers for Disease Control and Prevention (CDC). However, most may actually be able to safely use penicillin, either because they never were truly allergic or because they have lost sensitivity over time.
“Understanding penicillin allergy is important,” says Tonya Winders, President and CEO of Allergy & Asthma Network, the leading nonprofit patient education organization for people with asthma and allergies. “It kills 400 people a year. However, studies show many people who believe they are allergic to penicillin really are not. This mistaken belief leads to higher drug costs, inferior medical treatments and possible antibiotic resistance. If you think you are allergic to penicillin, see a board-certified allergist for testing. Don’t wait until you’re in a medical crisis.”
Here are the top 5 things the Network wants you to know about penicillin allergy:
1 – Penicillin allergy is serious and can be life-threatening. Anyone who is allergic to one type of penicillin should be considered allergic to all penicillins and avoid the entire medication group. This group includes more than 15 chemically related drugs, such as ampicillin, amoxicillin, amoxicillin-clavulanate and methicillin. If you are allergic to penicillin, talk with your physician and pharmacist before taking any new medicine you are prescribed to confirm that it’s not penicillin-based. Ask whether you should carry an epinephrine auto-injector, the only treatment proven to stop anaphylaxis, a life-threatening allergic reaction.
2 – Penicillin allergy may not be a lifelong condition – a reaction in childhood does not automatically predict a reaction as an adult. Only about 20 percent of people will be allergic to penicillin 10 years after their initial allergic reaction if they are not exposed to it again during this time period.
3 – Penicillin allergy symptoms may include hives, swelling of the mouth or throat, difficulty breathing or dizziness. Hives that suggest true allergy are raised, intensely itchy spots that may appear and change within hours – but not all skin rashes are hives. Non-allergy-related rashes may be flat, blotchy, and spread over days rather than hours. Since it may be difficult to tell the difference, and you can’t always get to a doctor right away, take a photograph of the rash to help with the diagnosis.
4 – Avoiding penicillin if there isn’t an allergy diagnosis is not the best idea. Alternative antibiotics to penicillin – often called “broad-spectrum” – may be less effective in treating your infection, may cause unwanted side effects or may be more expensive. Don’t limit your treatment choices – find out for sure whether you are allergic.
5 – Testing for penicillin allergy is safe and reliable. The process is simple. First, the patient undergoes a series of skin prick tests, using gradually increasing amounts of penicillin. A raised wheal at the site of the prick indicates allergy. If the tests are negative, the next step is an oral challenge – drinking liquid penicillin. These tests should always be conducted by an allergist trained to recognize and treat potential allergic reactions.
“Anyone who believes they are allergic to penicillin because they had a reaction years ago should undergo testing with a board-certified allergist,” says Courtney Blair, MD, board-certified allergist in McLean, Virginia and an Anaphylaxis Community Experts (ACE) volunteer with Allergy & Asthma Network. “If you are found to be allergic, then you’ll have a confirmed diagnosis and will know what to avoid. If you’re not, then you’ll know that if you need penicillin, you can take it without concern.
When you’re facing a medical treatment, you want the best possible care. Why limit your treatment to less effective drugs, or those with potentially more serious side effects? Talk with your physician about your past reactions with penicillin, and see a board-certified allergist to determine if testing is warranted.