Skin prick testing uses needles lancets that barely penetrate the skin's surface. You won't bleed or feel more than mild, momentary discomfort. Intradermal skin testing is the second part of the evaluation and involves injecting the skin. The test, if positive, will cause local itching and redness with swelling at the site where the test is performed. These reactions usually resolve in an hour or so. If I'm allergic to penicillin, but I have an infection where only a penicillin will work, what do I do?
The answer to this is somewhat dependent on the type of reaction you experienced. However, if you have had specialized testing in the past that has indicated you are allergic to penicillin such as a skin test or oral challenge and have an infection that requires immediate treatment, the safest approach is to perform a procedure called desensitization.
The typical process of desensitization has excellent success for patients who have experienced immediate reactions to penicillin and involves introduction of very tiny doses of the penicillin drug either orally or intravenously every minutes over a period of 4 hours or so.
At the end of this process, most patients can be safely treated with penicillin and dosed normally. However the procedure is only temporary and once treatment has finished, a repeat desensitization would be required if the antibiotic is needed again in the future.
Do I need to avoid other drugs if I am allergic to penicillin? It is generally recommended that you avoid all drugs in the immediate penicillin family amoxicillin, ampicillin, amoxicillin-clavulanate, dicloxacillin, nafcillin, piperacillin-tazobactam as well as certain drugs in the cephalosporin class a closely related class to penicillins. Therefore, even with a true allergy to penicillin, there is an excellent chance you could tolerate cephalosporins. Do I need to carry an epinephrine autoinjector for emergencies?
In general, it is not recommended that patients who have a history of penicillin allergy carry an epinephrine autoinjector. Find out more about drug allergies. Penicillin Allergy — what do you need to know? Skin prick testing is usually not painful. Intradermal skin testing is the second part of the evaluation and involves injecting the skin. The test, if positive, will cause local itching and redness with swelling at the site where the test is performed. It is generally recommended that you avoid all drugs in the immediate penicillin family amoxicillin, ampicillin, amoxicillin-clavulanate, dicloxacillin, nafcillin, piperacillin-tazobactam as well as certain drugs in the cephalosporin class a closely related class to penicillins.
Therefore, even with a true allergy to penicillin, there is an excellent chance you could tolerate cephalosporins. So, what do you need to know about Penicillin? What is penicillin? How common in penicillin allergy? How do I know if I am still allergic to penicillin?
Is penicillin allergy genetic? Is skin testing painful and what are the risks? If necessary seek advice from ID or Microbiology. What about other types of antibiotics? Tetracyclines e. Prescribing Issues A lways identify and document the nature of the reported allergy and drug name on the medicine chart and in the medical notes. What should be prescribed for truly penicillin allergic patients?
Click here for information on which antibiotics should be avoided in penicillin allergy, those that should be used with caution, and those that are safe. Ref: Pegler S, Healy B. BMJ ; Back to top. Urinary Tract Infections. Trimethoprim or nitrofurantoin.
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