Penicillin Allergy

Introduction

10% of the people in the United States report that they are allergic to penicillin/amoxicillin. However, studies have shown that 98% of patients who were labeled as penicillin allergic can actually take penicillin after an appropriate allergy evaluation, which often includes an in-office oral challenge. A person who is labeled as penicillin allergic may be exposed to broader–spectrum antibiotics when sick that may be more costly, less effective, have more risk of side effects, and may increase the risk of developing antibiotic resistance in the future.

Symptoms

Symptoms of penicillin allergy include hives, other rashes, swelling, vomiting, difficulty breathing.

Diagnosis/management

Your board-certified allergist will take a detailed history to determine the best management plan. This may include direct oral challenges in patients with low-risk histories or it may include penicillin skin testing first as an intermediate step. If skin testing is negative, a subsequent oral challenge will be recommended. If it is positive, this may indicate an allergy and continued avoidance may be recommended.