Q: Should people who believe they are allergic to penicillin get tested to confirm it? How would not having a penicillin allergy improve a patient’s health outcomes?
Allison Ramsey, MD: Penicillin allergy is the most commonly reported drug allergy in the United States. About 10% of the population report a penicillin allergy, but upon evaluation, only 1% of people actually have it.
So that means 90% of people who report a penicillin allergy are actually able to tolerate the medication.
People who believe they are allergic to penicillin should undergo testing and confirm if they really have a penicillin allergy.
From an individual health standpoint, having a penicillin allergy reduces access to this important class of antibiotics. It means patients are prescribed other types of antibiotics that are more expensive and have a higher risk for side effects.
From a public health standpoint, avoiding penicillin-based antibiotics when they are indicated for an infection can result in increased length of stay at hospitals. It can also result in antimicrobial resistance. This occurs when the bacteria that causes illness changes in ways that make the medications used to treat it ineffective.
Penicillin allergy testing is safe and reliable. It should only be done in a medical facility by an allergist trained to recognize and treat allergic reactions.
Allergists evaluate patients using either a skin prick test or a direct challenge using a dose of liquid penicillin.
Allergists know the benefits to removing a penicillin allergy from a patient’s medical records. Both children and adults with penicillin allergy on their medical records are urged to undergo testing to determine if they can gain access to these important antibiotics.
Allison Ramsey, MD, FACAAI, is a board-certified allergist and immunologist in Greece, New York and is affiliated with Rochester Regional Health. She is a Fellow of the American College of Allergy, Asthma and Immunology (ACAAI).