Penicillin allergy skin testing: What do we do now?

Jeremy A. Schafer, Noe Mateo, Garry L. Parlier, John C. Rotschafer

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations

Abstract

Drug-induced anaphylaxis remains a relatively infrequent event. However, penicillin and associated β-lactam antibiotics remain a primary cause of anaphylaxis. Penicillin allergies are undoubtedly overreported, and patients with suspected penicillin allergy can be treated with antibiotic alternatives. Penicillin allergy skin testing is a simple and effective way to identify true penicillin allergy. Skin testing involves testing for both major and minor determinants and should be conducted in a facility with available life-support equipment. The commercial major determinant product, benzylpenicilloyl- polylysine, was removed from the market in 2004; this action compromised the ability of clinicians to evaluate a patient's likely response to penicillin therapy. Alternatives to skin testing include laboratory synthesis of major determinants, use of the radioallergosorbent test (RAST), or a combination of RAST and minor determinant skin testing. Patients with suspected penicillin allergy can undergo desensitization if they require penicillin therapy. The planned return of a commercial major determinant will hopefully resolve this issue.

Original languageEnglish (US)
Pages (from-to)542-545
Number of pages4
JournalPharmacotherapy
Volume27
Issue number4
DOIs
StatePublished - Apr 2007

Keywords

  • Benzylpenicilloyl-polylysine
  • Penicillin allergy
  • PrePen
  • RAST
  • Radioallergosorbent test
  • Skin test

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