Penicillin Allergy Treatment
Penicillin allergy is an adverse reaction to antibiotics from the penicillin family. It occurs when a person has a true allergy to the drug, which can cause systemic symptoms such as shortness of breath, loss of consciousness, and even anaphylaxis. People who are penicillin allergic may have mild reactions, such as rashes or hives, but in severe cases, the person could be hospitalized due to difficulty breathing. Antibiotics from other classes can still be used to treat bacterial infections when a person has a penicillin allergy. However, they may not always be as effective in treating the infection.
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The Benefits of Penicillin Allergy Treatment
Treating a penicillin allergy is essential for individuals affected to ensure the successful treatment of a bacterial infection without the risk of serious or life-threatening allergic reactions. The benefits of penicillin allergy treatment include decreasing the risk of an adverse reaction to penicillin, using effective antibiotics when needed, and providing proper guidance and education to patients.
When treating a patient with a drug allergy, it is important that the healthcare professional obtains an accurate and detailed medical history and reviews any previous medical records regarding allergies. Allergy testing may be recommended if the cause of the allergic reaction is unclear.
This testing can identify which medication allergies an individual has, as well as any common penicillins they may be allergic to, to determine an alternative antibiotic if required. In addition, it can help identify individuals at risk for developing severe symptoms upon exposure to penicillin drugs.
Once the cause of the allergic symptoms is identified, therapeutic doses can be administered under close supervision by a physician to safely treat an infection while avoiding further harm due to an adverse reaction.
Signs of Penicillin Allergy
Mild symptoms include a skin rash, itching, hives, joint pain, and throat tightness. Severe reactions can include anaphylaxis and epidermal necrolysis. Symptoms such as abdominal pain, runny nose, and fever are also possible. It is important to be aware of the signs of a true penicillin allergy before taking any oral dose or injectable form of the antibiotic.
Reactions to Penicillin
When taking any type of medication, it is important to be aware of potential side effects or reactions that could occur. Signs that may indicate an allergic reaction to penicillin include skin redness or rash, itching or swelling, and difficulty breathing. A hypersensitivity reaction to the drug may also present itself in the form of serum sickness or drug rash with fever and swollen lymph nodes. In more severe cases, there may be an anaphylactic reaction that requires emergency medical attention right away.
Diagnosis for Penicillin Allergy
To properly diagnose and treat a penicillin allergy, healthcare professionals need to take a careful history of any previous allergic reactions as well as ask about related medications taken in the past, such as amoxicillin or cephalosporins. This information can help determine if there is a true allergy and then guide treatment decisions accordingly. If testing proves that an individual has a true penicillin allergy, then antibiotics from other classes, such as macrolides or tetracyclines, can still be used for infections such as strep throat, sinus infections, dental infections, and others caused by bacteria susceptible to these drugs to successfully treat the infection without putting the patient at risk for an adverse reaction.
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Test Options for Detecting Penicillin Allergy
During penicillin allergy tests, medical professionals carefully monitor patients for safety. Multiple tests are available to diagnose penicillin allergy, each varying in accuracy:
Skin Prick Test
Known as scratch testing, the skin prick test detects penicillin allergy. A small penicillin amount is applied to the skin and pricked with a needle to introduce the allergen. A positive reaction manifests as a red, itchy bump, indicating a possible allergy. This safe and minimally invasive test is commonly used.
RAST Blood Test
The RAST blood test measures allergen-specific antibodies (IgE) in the blood. Detecting a penicillin allergy is less accurate than skin testing and may yield false results.
Intradermal Testing
Intradermal testing injects penicillin under the skin, often on the forearm. More sensitive than skin prick testing, it may yield false positives due to its lower specificity.
Oral Drug Test
The oral provocation challenge administers increasing penicillin doses and observing reactions. This definitive test directly monitors responses but carries a higher risk of severe reactions. It is reserved for cases where other tests are inconclusive or inappropriate.
Treat Penicillin Allergy at Penn Medicine Becker ENT & Allergy
Antihistamines
Antihistamines alleviate mild to moderate penicillin allergy symptoms like itching and hives. Forms include oral tablets, liquids, creams, and gels. Over-the-counter choices comprise diphenhydramine (Benadryl), cetirizine (Zyrtec), and loratadine (Claritin).
Corticosteroids
Corticosteroids reduce inflammation and severe penicillin allergy reactions. Administered orally or by injection for short-term use, they include prednisone, methylprednisolone, and hydrocortisone.
Immunotherapy (Desensitization)
Immunotherapy gradually increases penicillin doses, building tolerance. Done under supervision over hours or days, it’s for confirmed penicillin allergy patients under professional guidance.
Epinephrine Injections
Epinephrine injections like EpiPens treat severe allergic reactions, including anaphylaxis. Rapidly reversing symptoms like breathing difficulties and swelling, they are crucial for emergencies. Immediate medical attention is vital after use.
Risks Associated with Ignoring a Penicillin Allergy
Ignoring a penicillin allergy may be extremely dangerous, leading to severe anaphylaxis, a life-threatening allergic reaction. Symptoms of anaphylaxis include hypotension (low blood pressure), difficulty breathing, and rapid swelling of the face or throat. In some cases, a patient can have a cross-reactive drug reaction to other antibiotics if they unknowingly take even a small dose of penicillin when they are allergic, so it is important to be aware of any potential allergies before taking any type of antibiotic.
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Why Choose Our Specialists?
- Dr. Elias Akl, is a distinguished allergist and immunologist based in Philadelphia. He holds board certifications in Allergy and Immunology as well as Internal Medicine, showcasing his expertise in multiple medical disciplines. Dr. Akl is not only board-certified in internal medicine but also a Fellow of the American Academy of Allergy Asthma and Immunology (FAAAAI).
- Dr. Kathryn Edwards, Director of Allergy & Immunology at The Penn Medicine Becker ENT & Allergy Center, is a board-certified allergist and immunologist who specializes in the diagnosis and treatment of allergies, food allergies, skin conditions, and asthma. She is a highly trained physician with extensive experience in the military, where she served as a pediatrician and chief of Allergy/Immunology. Dr. Edwards provides care for patients of all ages, from neonates to geriatrics.
- Dr. Naba Sharif is a highly skilled board-certified Allergist and Immunologist with expertise in diagnosing and treating allergies, including environmental and seasonal allergies, food allergies, and asthma. She received her medical degree from SUNY at Stony Brook School of Medicine, completed a Pediatrics residency at Hasbro Children’s Hospital of Brown University, and pursued a fellowship in Allergy and Immunology at the North Shore-Long Island Jewish Health System. She practiced as a Pediatrician and Allergist-Immunologist at Kaiser Permanente in Washington DC, was recognized as a Top Doctor by Washingtonian Magazine from 2016 to 2020, and is a Fellow of the American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma & Immunology. Dr. Sharif is committed to community service, health education, empowerment, and advocacy for the underprivileged.
- Dr. Jamie Zacharias is a highly accomplished and board-certified Allergist and Immunologist hailing from South Jersey. She pursued her education in her hometown, graduating from Bishop Eustace Preparatory School, and furthered her academic journey by earning her bachelor’s and medical degrees from Drexel University and the College of Medicine in Philadelphia, PA. Dr. Zacharias continued her medical training with an Internal Medicine internship and residency at Drexel University College of Medicine/Hahnemann University Hospital. Following this, she completed a comprehensive Allergy and Immunology fellowship at Penn State Hershey Medical Center, where she actively engaged in asthma research, particularly focusing on patient demographics and phenotyping. Dr. Zacharias holds memberships in esteemed organizations such as the Pennsylvania Allergy and Asthma Association, the American Academy of Allergy, Asthma, and Immunology, and the American College of Allergy, Asthma, and Immunology. Her specialization encompasses the diagnosis and treatment of various conditions, including asthma, immunodeficiencies, seasonal and environmental allergies, allergic reactions (including drug and food allergies), and skin conditions such as hives and eczema. Dr. Zacharias is dedicated to providing care across a wide age spectrum, from pediatric to geriatric patients, and she is excited to contribute to the well-being of her community where she has deep roots.
Frequently Asked Questions about Penicillin Allergy
We understand that you may have additional questions regarding penicillin allergy treatment. To help address some common concerns, we have compiled a list of frequently asked questions and their answers.
