Penicillin Allergy Is Often Overreported

A majority of patients who were supposedly allergic to penicillin had negative responses to penicillin skin testing (PST), according to a recent study.

Penicillin allergy has significant clinical implications, and it is therefore important to identify characteristics of patients with the allergy, and to identify patients who have been mislabeled as allergic.
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The researchers retrospectively reviewed PST data from April 2017 to June 2017. Patients were offered PST, followed by an amoxicillin challenge with 30 minute observation if PST was negative. The average duration of PST was 71 minutes.

Overall, a total of 119 of 755 patients reported penicillin allergy. PST was conducted in 48 of the 119 patients, and, of those, 41 were negative (85.4%). Of the remaining penicillin-allergic patients, 20 were taking interfering medications, 7 reported a delayed reaction, 5 reported anxiety or needle fear, 5 had time constraints, 5 had had a recent reaction, 4 had recent positive PST results, 8 patients were scheduled for future PST, and 11 were not tested for other reasons.

“Our analysis provides a real world representation of the feasibility of PST and illustrates that QI projects aimed at PCN SPT can improve its utilization,” the researchers concluded.

—Michael Potts

Reference:

Mustafa SS, Ramsey A. A penicillin skin testing initiative in an outpatient allergy practice [presented at ACAAI 2017]. October 29, 2017. Boston, Massachusetts. Abstract OR005.